Patellar Contact Pressure Changes With Anteromedialization of Tibial Tubercle, Lateral Release, and New Technique for Elevating Quadriceps Tendon: A Biomechanical Study

Abstract

Anteromedialization of the tibial tubercle has been shown to unload contact pressure in the distal and lateral region. No study has evaluated pressures after anteriorization of the quadriceps tendon as a way to decrease contact pressures at the patella. In this controlled laboratory study, six cadaveric knees were tested by placing Fuji pressure film to measure patellar contact area, pressure, and force at 0°, 30°, 60°, and 90° in the intact state and after anteromedialization of the tibial tubercle, lateral release, and anteriorization of the quadriceps tendon. The addition of anteriorizing the quadriceps tendon decreased patellar contact area and force in the distal and lateral patella more than anteromedialization of the tibial tubercle and lateral release alone, though not in the proximal aspects of the patella as hypothesized.