Focus on the tubercle transfer: Avoid complications, choose fixation

Tubercle transfer is a surgical technique used to correct patellar tracking issues, often performed to address conditions like patellar instability and patellofemoral pain syndrome. The procedure's effectiveness depends on careful planning, precise execution, and the right fixation strategy. Here’s how to reduce risks and select the best fixation method. 

Understanding Tubercle Transfer 

The tibial tubercle is the bony structure where the patellar tendon connects. In a procedure called tibial tuberosity osteotomy (TTO), surgeons reposition this area to improve patellar alignment and function. This adjustment helps correct misalignment, alleviate pain, and reduce the chances of recurring dislocations. 

Common Complications and How to Avoid Them 

Delayed healing or nonunion can occur if the bone is not adequately prepared and stabilized. To promote proper recovery, it is essential to use secure fixation methods and follow weight-bearing restrictions and rehabilitation protocols. Tibial fractures may result from excessive bone removal, so preserving structural integrity and employing precise osteotomy techniques is crucial. Surgical hardware issues, such as loosening or irritation, can be minimized by using high-quality biocompatible materials and regular postoperative imaging. Improper correction of tubercle movement can lead to misalignment, making preoperative imaging and intraoperative assessments vital for accuracy. Additionally, soft tissue discomfort can be reduced by limiting tissue disruption and opting for low-profile implants. 

Choosing the Right Fixation Method 

Selecting the right fixation method is crucial for stability and healing after tubercle transfer surgery. Screws offer strong support but may require removal if they cause irritation. Plates with screws provide extra stability for complex cases but can feel bulky. Suture-based fixation minimizes hardware-related issues but may not be strong enough for larger bone transfers. Bioabsorbable implants remove the need for future surgery, though their strength varies. The best option depends on the patient’s condition and the surgeon’s expertise. 

Conclusion   

Successful tubercle transfer surgery relies on precision, expertise, and the right fixation approach to optimize recovery. A thorough understanding of potential challenges and best practices ensures better patient outcomes and long-term joint stability. For expert surgical care and personalized treatment, visit London Ortho and take a step toward enhanced mobility and recovery
- By Dr. Adhith Sugavanam