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Vet Comp Orthop Traumatol 2014; 27(04): 271-276
DOI: 10.3415/VCOT-13-12-0150
Original Research
Schattauer GmbH

Tibial tuberosity transposition-advancement for lateralization of the tibial tuberosity: An ex vivo canine study

M. Newman
1   University Veterinary Teaching Hospital- Sydney University of Sydney, New South Wales, Australia
,
N. Bertollo
2   Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia
,
W. Walsh
2   Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia
,
K. Voss
1   University Veterinary Teaching Hospital- Sydney University of Sydney, New South Wales, Australia
› Author Affiliations
Further Information

Publication History

Received: 12 December 2013

Accepted: 19 May 2014

Publication Date:
20 December 2017 (online)

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Summary

Objectives: To evaluate the degree of lateralization achievable and strength of tibial tuberosity transposition and advancement (TTTA) relative to pin and tension band wiring (PTBW) for lateral tibial tuberosity transposition.

Methods: Six pairs of cadaveric tibiae were used. Tibial tuberosity position was determined with computed tomography (CT); bones were then randomly assigned into TTTA and PTBW groups. The PTBW group had a tibial tuberosity osteotomy and fixation with pin and tension band wiring. The TTTA group had a tibial tuberosity advancement performed with lateralization of the tibial tuberosity by 50% of cage depth, using spacers on the cranial cage screw. Postoperative CT images showed lateralization and craniocaudal deviation. Single axial distractive loading was applied to the patella at 90° to the tibial plateau, and peak load, energy, and stiffness were calculated.

Results: There were significant differences in lateralization (PTBW: 67.92 ± 5.1 %; TTTA: 88.51 ± 5.5 %) (p = 0.0173) and craniocaudal deviation (PTBW: –8.30 ± 1.4 %; TTTA: 6.83 ± 0.6) (p = 0.0001). There were no significant differences in peak load to failure (N) (PTBW: 1448 ± 121; TTTA: 1597 ± 43) (p = 0.4541), energy to failure (N/mm) (PTBW: 15013 ± 2719; TTTA: 17314 ± 887) (p = 0.646), or stiffness (N/mm)(PTBW: 102.8 ± 4.7; TTTA: 92.9 ± 4.8) (p = 0.2716).

Clinical significance: The TTTA was more effective at lateralization of the tibial tuberosity, and of comparable strength to PTBW. Greater support of the osteotomized fragment with TTTA may resist cyclic loading, and requires evaluation.

Keywords

Tibial tuberosity advancement - medial patellar luxation - tibial tuberosity transposition - orthopaedic implants
 

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