Скачать или смотреть Patellar dislocation can be treated well with TTO ..tibial tubercle osteotomy

"MPFC Advancement with TTO" is a variation in the surgical treatment of patellar instability, often chosen when the MPFL is intact but lax (not torn) and the bony alignment is abnormal.


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Breakdown of the Terms:

1. MPFC Advancement

MPFC = Medial Patellofemoral Complex, which includes:

MPFL (medial patellofemoral ligament)

Medial retinaculum

Vastus medialis obliquus (VMO) fibers


MPFC advancement means:

Instead of reconstructing the ligament with a graft (as in MPFL reconstruction), the intact but stretched native MPFL/retinaculum is surgically advanced and re-tensioned.

This is done by reattaching it more medially or proximally on the patella.

It’s a soft tissue tightening procedure that preserves native anatomy.

Ideal for skeletally immature patients, or those without full MPFL tear.


2. TTO (Tibial Tubercle Osteotomy)

Done to correct underlying bony alignment issues (like lateralized or high patella).

Helps realign the patella by shifting the tibial tubercle medially (Elmslie-Trillat), distally (for patella alta), or both.



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Indications for Combined MPFC Advancement + TTO:

Recurrent patellar dislocation/subluxation

High TT-TG distance or patella alta

MPFL is intact but lax

Preference for non-graft soft tissue procedure

Younger patients where you want to avoid tunnels in physis (growth plate)



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Advantages:

Avoids allograft/hamstring harvest

Preserves native MPFL structure

Good for skeletally immature or mild instability cases

TTO addresses the bony maltracking, while MPFC advancement restores soft tissue restraint



educational content from Advance Hospitals / Dr. Prathmesh Jain