Clinical Outcomes of Tibial Tubercle Transfer for Anterior Knee Pain and Patello-femoral Instability

Abstract

Anterior knee pain and patellofemoral instability have a multi-factorial aetiology and are therefore difficult to treat. A variety of surgical treatment options have been proposed for such patients. Tibial tubercle transfer is one such option and has been described using different surgical techniques. There is however a paucity of literature regarding the procedure itself and its clinical outcomes. Purpose: This study describes the clinical efficacy and outcome of a Tibial Tubercle Transfer (TTT). Study Design: Case series. Methods: 86 consecutive patients who underwent TTT for anterior knee pain and/or patellofemoral instability were studied prospectively. All patients received the same rehabilitation protocol postoperatively. Clinical outcome was measured using the Kujala knee score pre-operatively and at follow-up. Patients were also asked to rate their satisfaction with the procedure. Mean duration of follow up was 1.7 years (6 months to 3 years). Results: 94% of patients were satisfied with their decision to undergo the operation at the latest follow up. The mean Kujala score pre-operatively was 46 points with a Standard deviation (SD) of 14.35. At 6 months the mean Kujala score had improved to 70 points with a standard deviation of 20.25. Patients with patella-femoral instability alone showed greater improvement of Kujala scores compared to patients with anterior knee pain alone or pain plus instability. Conclusion: Our experience suggests that tibial tubercle transfer provides a safe and effective surgical treatment option for patients with anterior knee pain and patellofemoral instability. Patients with patellofemoral instability preoperatively derived the most benefit.