{"id":26545,"date":"2025-07-16T11:29:00","date_gmt":"2025-07-16T08:29:00","guid":{"rendered":"https:\/\/www.utkuerdemozer.com\/?p=26545"},"modified":"2025-08-15T15:39:04","modified_gmt":"2025-08-15T12:39:04","slug":"tibial-tubercle-fulkerson-osteotomy","status":"publish","type":"post","link":"https:\/\/www.utkuerdemozer.com\/en\/tibial-tubercle-fulkerson-osteotomy\/","title":{"rendered":"Patellar Dislocation and Patellofemoral Arthritis Surgery: Tibial Tubercle (Fulkerson) Osteotomy"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Tibial tubercle osteotomy is an effective surgical method used to treat certain structural problems of the kneecap. It can provide a permanent solution, especially for patients with <strong><a href=\"https:\/\/www.utkuerdemozer.com\/en\/knee-cap-dislocation-patella\/\">patellar dislocation<\/a><\/strong> or those experiencing pain due to patellofemoral arthritis. This surgery ensures that the kneecap moves in alignment with the knee and along the correct track.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">During this surgical procedure, the bony prominence beneath the kneecap (tibial tubercle) is cut at a specific angle and moved to the front and inner side of the knee (anteromedial direction). This allows:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>In patients with patellar dislocation, lateral displacement of the patella is prevented, resulting in a more stable knee structure.<\/li>\n\n\n\n<li>In patients with patellofemoral arthritis, the bone is shifted further forward, reducing joint pressure and relieving pain.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The primary goal of this surgery is to correct load distribution. However, in some patients, there is also localized cartilage loss in the patellofemoral joint. In such cases, tibial tubercle osteotomy can be combined in the same session with additional <a href=\"https:\/\/www.utkuerdemozer.com\/en\/cartilage-transplantation\/\">cartilage restoration procedures<\/a> such as mosaicplasty or autologous chondrocyte implantation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This surgery provides a permanent solution for patients suffering from patellar dislocation and is also an effective surgical option for those with pain caused by patellofemoral arthritis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What Is Tibial Tubercle Osteotomy?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In this procedure, the structure connecting the lower end of the patella to the shinbone (tibial tubercle) is cut along with the bone and anatomically repositioned. This process is called an osteotomy.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The aim is to correct the malalignment of the patella and prevent recurrent dislocations.<\/li>\n\n\n\n<li>It also reduces the load on the cartilage underneath the patella, relieving <a href=\"https:\/\/www.utkuerdemozer.com\/en\/anterior-knee-pain\/\">anterior knee pain.<\/a><\/li>\n\n\n\n<li>In patients with patellofemoral cartilage problems who are considered too young for total knee replacement, this method helps preserve the joint.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>When Is Tibial Tubercle Osteotomy Performed?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tibial tubercle osteotomy is performed in two main clinical situations:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Recurrent patellar dislocation and patellar instability:<\/strong> When the patella repeatedly dislocates or feels as if it will dislocate, it causes instability, insecurity, and loss of function. Tibial tubercle osteotomy corrects the anatomical abnormality causing the dislocation, restoring knee stability.<\/li>\n\n\n\n<li><strong>Patellar cartilage damage and patellofemoral arthritis:<\/strong> When cartilage wear is concentrated in the patellofemoral joint, it can cause severe pain and movement limitations. Changing the position of the tibial tubercle redistributes load and reduces pressure on the joint.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In addition to these main indications, surgery may also be considered in:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Early cartilage wear in the patellofemoral joint (without advanced patellofemoral arthritis)<\/li>\n\n\n\n<li>Patellofemoral pain syndrome<\/li>\n\n\n\n<li>Patients who do not respond to physiotherapy, injections, or other non-surgical treatments<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Tibial Tubercle Osteotomy (TTO) for Patellofemoral Arthritis<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tibial tubercle osteotomy is not only performed for patellar dislocation or instability, but it is also an effective treatment option for patients with patellofemoral arthritis (isolated patellofemoral osteoarthritis).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This condition typically presents with anterior knee pain during:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Climbing stairs<\/li>\n\n\n\n<li>Sitting for prolonged periods<\/li>\n\n\n\n<li>Walking downhill<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">If cartilage damage is limited to the joint between the kneecap and the femur, and the other parts of the knee are healthy, shifting the tibial tubercle forward and inward (anteromedialization) offers several advantages:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Reduces pressure beneath the patella<\/li>\n\n\n\n<li>Alters the direction of loading that damages cartilage surfaces<\/li>\n\n\n\n<li>Significantly relieves pain<\/li>\n\n\n\n<li>Delays or completely avoids the need for <a href=\"https:\/\/www.utkuerdemozer.com\/en\/knee-replacement\/\">total knee replacement<\/a><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Particularly in patients who are not yet of advanced age and are considered too young for total knee replacement, tibial tubercle osteotomy is a joint-preserving surgical option that improves quality of life.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you\u2019d like, I can now <strong>add a treatment outcomes and recovery section in English<\/strong> so this becomes a <strong>complete, SEO-optimized page<\/strong> ready for your site that covers indications, surgical details, benefits, and recovery expectations for tibial tubercle osteotomy. Would you like me to prepare that?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Here\u2019s your text translated <strong>word-for-word<\/strong> into <strong>SEO-friendly English<\/strong>, keeping all medical details, headings, and structure intact:<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Can Tibial Tubercle Osteotomy Be Performed Together with MPFL Surgery?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Yes, tibial tubercle osteotomy is often performed together with MPFL reconstruction (medial patellofemoral ligament repair). Especially in patients with patellar dislocation, correcting both the bony structure (tibial tubercle) and the soft tissue (MPFL) provides more permanent and effective results.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If necessary, this surgery can also be combined with other procedures such as cartilage repair (mosaicplasty, microfracture) or trochleoplasty (reshaping the patellar groove). This way, both the anatomical alignment and the stability of the patella can be restored in a single session.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The combination of tibial tubercle osteotomy and MPFL reconstruction is a common and successful treatment option for recurrent patellar dislocations, complex patellar instability, and patients with multiple structural abnormalities.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>How Is Tibial Tubercle Osteotomy Surgery Performed?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Anesthesia:<\/strong> General (completely asleep) or spinal (numbed from the waist down)<\/li>\n\n\n\n<li><strong><a href=\"https:\/\/www.utkuerdemozer.com\/en\/knee-surgery\/\">Arthroscopy:<\/a><\/strong> In the first stage, the knee joint is visualized with a camera to evaluate cartilage tissue and address any additional problems if present<\/li>\n\n\n\n<li><strong>Open surgery:<\/strong> A 9\u201314 cm incision is made on the front of the knee<\/li>\n\n\n\n<li><strong>Tibial tubercle osteotomy:<\/strong> A 6\u20138 cm piece of bone is shifted forward and inward (anteromedialization) and fixed with 2\u20133 screws<\/li>\n\n\n\n<li><strong>Drainage:<\/strong> If necessary, a surgical drain is placed for one day<\/li>\n\n\n\n<li><strong>Sutures:<\/strong> Typically closed with absorbable sutures (no removal needed)<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Postoperative Recovery Process<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Day 1:<\/strong> The leg is kept straight in an immobilizer brace. First mobilization and walking begin with a physiotherapist, using two crutches.<\/li>\n\n\n\n<li><strong>Weeks 1\u20133:<\/strong> Walking with two crutches and a knee brace<\/li>\n\n\n\n<li><strong>Weeks 3\u20135:<\/strong> Walking with a single crutch, gradually reducing brace use<\/li>\n\n\n\n<li><strong>After Week 6:<\/strong> Walking without assistance, starting muscle-strengthening exercises<\/li>\n\n\n\n<li><strong>Months 2\u20133:<\/strong> Light activities (swimming, stationary cycling)<\/li>\n\n\n\n<li><strong>Months 6\u20138:<\/strong> Gradual return to running and contact sports<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Frequently Asked Questions About Tibial Tubercle Osteotomy<\/strong><\/h2>\n\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list \">\n<div id=\"faq-question-1\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Do I need to use crutches or a walker after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Yes. In the first few weeks after surgery, the knee cannot bear full weight, so crutches or a walker are necessary. Support is usually needed for 4\u20136 weeks, after which gradual weight-bearing begins.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-2\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is swelling and bruising normal after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Yes, some swelling and bruising around the knee after surgery is normal. Applying ice and keeping the leg elevated during the first 1\u20132 weeks helps reduce these symptoms.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-3\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When are sutures removed after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>If absorbable sutures are used, they do not need to be removed. If non-absorbable sutures are used, they are typically removed around days 12\u201314.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-4\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">How long does pain last after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Pain is normal in the first days and can usually be controlled with painkillers. It gradually decreases over the first few weeks. Regular physiotherapy makes recovery more comfortable.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-5\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When can I climb stairs after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Usually after the 6th week, once the knee can bear weight in a controlled manner. This process should be guided by a physiotherapist.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-6\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">How long does full recovery take after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Most patients return to normal daily life within 4\u20136 months. Regaining full muscle strength and sports performance may take 6\u20139 months.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-7\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Is tibial tubercle osteotomy a permanent solution?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Yes. When performed with the correct indication, it corrects abnormal patellar movement and significantly reduces symptoms. However, in cases of severe cartilage damage, additional surgeries may be needed in the long term.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-8\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Will the screws used in tibial tubercle osteotomy be removed later?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>The screws used to fix the new patellar position are generally permanent. However, some patients may feel them under the skin. If they cause discomfort, they can be removed in a minor surgical procedure a few months later.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-9\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When does physiotherapy start after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Physiotherapy usually starts one day after surgery, while still in the hospital. After discharge, a controlled rehabilitation program continues with 2 sessions per week. This speeds up recovery and helps restore muscle strength.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-10\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When can I drive after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>For right knee surgeries, driving is usually not recommended until the 6th week. For left knee surgeries, patients can often return to driving in 3\u20136 weeks if they are not using painkillers and can comfortably control the knee.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-11\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When can I shower after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>With waterproof dressings, showering is usually possible from day 3\u20134, seated and with care.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-12\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When can I return to work after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Patients with desk jobs can usually return to work within 4\u20136 weeks. For physically demanding jobs, this period can extend to 10\u201312 weeks. The plan should be personalized according to recovery speed.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-13\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">When can I start sports and exercise after tibial tubercle osteotomy?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Low-impact activities such as swimming and stationary cycling can begin around 2\u20133 months postoperatively. High-impact activities such as running, fitness, tennis, and contact sports are usually allowed after 6 months, with the doctor\u2019s approval and under controlled conditions.<\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\"><strong>Conclusion<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tibial tubercle osteotomy is a joint-preserving and functional surgical procedure that can permanently resolve patellar dislocation and isolated patellofemoral arthritis pain. With proper patient selection, accurate surgical planning, and physiotherapy, the success rate is high.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tibial tubercle osteotomy is an effective surgical method used to treat certain structural problems of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":23516,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[48,49],"tags":[],"class_list":["post-26545","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-knee-surgery","category-sport-surgery-and-arthroscopy"],"_links":{"self":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26545","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/comments?post=26545"}],"version-history":[{"count":1,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26545\/revisions"}],"predecessor-version":[{"id":26546,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/posts\/26545\/revisions\/26546"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/media\/23516"}],"wp:attachment":[{"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/media?parent=26545"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/categories?post=26545"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/en\/wp-json\/wp\/v2\/tags?post=26545"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}