Outcomes of combined tibial tuberosity transfer and medial patellofemoral ligament reconstruction for recurrent patellar instability

Published online: Jun 27 2016

Gopalakrishna PEMMARAJU, James BASSETT, Raad ABBAS, Gurpreet NAGRA, Sanjiv CHUGH, Ejaz MUGHAL

From the Royal Wolverhampton NHS trust, New Cross Hospital,U.K.


Patellofemoral instability is multifactorial and is associated with pathomechanics secondary to anatomical variance. Surgical management of this problem must be tailored to each patient and a thorough clinical and radiological assessment of the anatomical alignment should be carried out pre-operatively. The aim of this study is to assess the role of medial patellofemoral ligament reconstruction combined with tibial tuberosity transfer in patients with increased tibial tuberosity to trochlear groove (TT-TG) distance. Twenty-four patients (27 knees) over 2-years were operated on by a single surgeon, with standardised post-operative rehabilitation and follow up. Mean follow up was 31-months. Two patients had problems with recurrent instability, 1 had a traumatic re-dislocation at 2 years and a total of 4 required further operation for complications. Mean post-operative Kujala scores were 87.4 (SD 9.8). Combined medial patellofemoral ligament reconstruction and tibial tuberosity transfer is an appropriate treatment for patients with increased TT-TG distance.