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

Tibial tubercle osteotomy (TTO) in total knee arthroplasty, is it worth it? A review of the... Introduction 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. Complica- tions 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. Materials and methods 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”. Results 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%. Conclusion TTO may be necessary to correct pathological tuberosity position or patella tracking. However, TTO is a chal- lenging 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Orthopaedic and Trauma Surgery Springer Journals

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

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Orthopedics
ISSN
0936-8051
eISSN
1434-3916
D.O.I.
10.1007/s00402-018-2888-y
Publisher site
See Article on Publisher Site

Abstract

Introduction 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. Complica- tions 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. Materials and methods 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”. Results 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%. Conclusion TTO may be necessary to correct pathological tuberosity position or patella tracking. However, TTO is a chal- lenging 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

Journal

Archives of Orthopaedic and Trauma SurgerySpringer Journals

Published: Jan 23, 2018

References

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