Tibial tubercle osteotomy (TTO) in total knee arthroplasty, is it worth it? A review of the literature

Autor: Stefano Divano, Matteo Formica, Stefano Biggi, Lamberto Felli, Andrea Camera, Stefano Tornago
Rok vydání: 2018
Předmět:
Zdroj: Archives of Orthopaedic and Trauma Surgery. 138:387-399
ISSN: 1434-3916
0936-8051
Popis: Tibial tubercle osteotomy (TTO) is a well-established extensile approach to improve joint visualization and implant removal. Despite this, TTO is a challenging technique with a long learning curve and potential pitfalls. Complications are not infrequent, even if performing the correct surgical steps. Aim of this paper is to review the current literature about TTO, its safeness and reliability, and finally the complications rate. We performed a systematic review of the available English literature, considering the outcomes and the complications of TTO. The combinations of keyword were “tibial tubercle osteotomy”, “total knee arthroplasty”, “total knee revision”, “outcomes”, “complication” and “surgical approach”. From the starting 322 papers available, 26 manuscripts were finally included. Most of the papers show significant improvements in clinical outcomes, both in primary and in revision procedures. Radiographic fragment healing is close to 100%. Related complications can range from 3.8–20%. TTO may be necessary to correct pathological tuberosity position or patella tracking. However, TTO is a challenging technique to improve the surgical approach during total knee arthroplasty. A strict surgical technique can lead to better results and to minimize complications. However, it is not clear if the improved outcome can outweigh the longer surgery and the higher risk of pitfalls.
Databáze: OpenAIRE