Abstract
This article sought to determine rates for return to work, pain relief, and recurrent
patellofemoral instability for military service members undergoing tibial tubercle
osteotomy (TTO) for persistent lateral patellar subluxation or dislocation. Patient
demographic and surgical variables were isolated from the medical records of active
duty service members with at least 2 years of postoperative follow-up, and correlated
with return to work, pain improvement, recurrent patellofemoral instability, and perioperative
complications. There were 51 service members (58 primary TTOs) with an average follow-up
of 3.3 (range, 2.0–6.7) years. Service members had an average of 2.8 (1–12) instability
events preoperatively. At a minimum of 2 years postoperatively, 41 (80%) military
service members returned to full active duty service. Among the 58 TTOs, there was
a 46% improvement in the patient-reported visual analog score from 4.1 to 2.2 (p < 0001). The postoperative recurrent instability rates were patellar dislocation
(5.1%) and patellar subluxation (15.5%). Concomitant proximal realignment was performed
in 48% of cases, which did not affect return to service, postoperative patellar instability
events, or pain improvement (p > 0.05). The overall complication rate was 10%. Postoperative tibial fractures occurred
in 6.9% of TTOs. At short- to mid-term follow-up, 80% of service members undergoing
TTO for patellofemoral instability returned to military duty with significant improvement
in pain scores and a moderate perioperative complication and postoperative instability
rate. This study is a level IV therapeutic case series.
Keywords
tibial tubercle osteotomy - anteromedialization - patellar instability - military
- functional outcome
