Tibial Tubercle Osteotomy Fulkerson Osteotomy?

Question

over a year ago i had a lateral release done on my knee, now its starting to hurt again, i went for a second opinion on what can be done to fix this and theres only one solution, its called a "Tibial Tubercle Osteotomy Fulkerson Osteotomy" Ive tried doing some research on this procedure and i havent found much. Basically what it is, is that they cut my tibial bone in half and re-attatch them to my knee so that the placement is no longer crocked and there isnt any stress left. The doc said its a 99% fix in all patients with this problem. Im just curious to see if anyone else has had this done, or know anyone who has, any info would be great. thanks!
Ohh by the way im only 22 and in perfect health and weight.

whats the down time?

Answer 1

A Tibial Tubercle Osteotomy with a Lateral Release varies from a Fulkerson Osteotomy in this sense:-
A tibial tubercle osteotomy moves and reinserts the patellar tendon into the shinbone (tibia). This procedure is commonly performed for one or a combination of conditions in which: A patella slips sideways (laterally), out of its vertical track. This is known as lateral patellar tracking. An excessively long patellar tendon allows the patella to slide too high on the knee joint (patella alta). A tibial tubercle osteotomy is usually combined with a lateral release. One cause of patellar tracking disorder is a tight lateral retinaculum, a ligament complex that anchors the outer edge of the patella. If your patella is being pulled to the side by a tight lateral retinaculum, a surgeon may recommend a lateral release. This procedure, performed arthroscopically, cuts the lateral retinaculum. Lateral release surgery is appropriate for only a small fraction of people with patellar tracking disorder, and may be used more often than is necessary.
In cases of patellar (kneecap) instability with recurrent subluxation (kneecap jumping over the edge of its groove), surgeons may attempt to improve the stability by realigning the patella by changing the forces through the whole patellar system - what is known as extensor mechanism. That is the quads muscle, quads tendon, patella, patellar tendon, tibial tubercle, and the side restraints of the patella (retinaculum). If the operation involves structures at or above the kneecap, it is called a proximal realignment. If the operation involves structures below the kneecap, it is called a distal realignment. The Fulkerson Procedure, or Fulkerson osteotomy, is a distal realignment procedure, where the tibial tubercle (the bony bump an inch below the kneecap) is cut and moved medially and anteriorly (ie towards the inner aspect and forwards). This has the effect of improving the extensor mechanism alignment, and also decreases the pressure under the patella.
Hope this helps
matador 89

Answer 2

Tibial Tubercle Osteotomy

Answer 3

I hadn't heard o this surgery before but am familiar with IT band syndrome. Relocating the patella ligament even slightly changes the kinetics of the knee and surgery can leave scar tissue and fascial adhesions. The IT band and it's attached muscles (Glute Max and Tensor Fascia Latae) may try to compensate and pull the IT band in such a way that it no longer glides straight and smoothly smoothly over the joint, bursa, and vastus lateralis muscle. Result, Irritation, inflammation, IT band syndrome. That's just one possibility. If I were facing surgery, or coping with the results of one, I would first seek the opinion of a Very Well Trained Massage Therapist (specializing in Body Work, not simply relaxation). Someone certiied in Neuromuscular Therapy, Feldenkrais, Hellerwork, serious sports work w/ athletes, will usually know more than one of those methodologies and be able to tailor technique to the specific issue, in addition to thoroughly assessing it. Note, this is different than Physical Therapy. Best of luck to you. Hope you can get it resolved.

Answer 4

Fulkerson Osteotomy