J Knee Surg 2015; 28(04): 279-284
DOI: 10.1055/s-0035-1544973
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tibial Tubercle Osteotomy: Indication and Techniques

Brian Grawe
1  Department of Orthopedic Surgery, University of Cincinnati Academic Health Center, Cincinnati, Ohio
Beth Shubin Stein
2  Department of Orthopedic Surgery, Weill Cornell Medical College, New York, New York
3  Hospital for Special Surgery, New York, New York
› Author Affiliations
Further Information

Publication History

24 November 2014

04 December 2014

Publication Date:
30 January 2015 (online)


Osteotomy of the tibial tubercle is a versatile procedure that can be utilized for several common pathologies about the patellofemoral joint. Most commonly, tuberosity transfer is employed for the treatment of patellar instability or symptomatic overload of the patella. The osteotomy can be combined with soft tissue realignment procedures or cartilage reconstructive techniques. A precise understanding of the surgical anatomy and the biomechanics of the patellofemoral articulation is essential for producing a successful outcome during surgery. Tailoring the direction of transfer to the pathoanatomy of each patient is critical for producing a durable and lasting result following a tibial tubercle osteotomy. When evaluating a patient for a possible transfer, a thorough history and physical evaluation must be undertaken, along with imaging to the patellofemoral joint. Several useful advanced imaging techniques can also be used to guide the surgeon toward the most appropriated osteotomy for the patient. The purpose of this article is to review the indications for performing a tibial tubercle osteotomy, and highlighting the various techniques for transfer.