Treatment varies depending on severity, ranging from medial patellofemoral ligament (MPFL) reconstruction, tibial tubercle
osteotomy or trochleoplasty (where the femur's distal aspect is cut and reshaped to create a more normal groove) to distal femoral osteotomy.
Because of the degenerative changes, some orthopedic surgeons would advocate a tibial tubercle
elevation, which has the capability of addressing the degenerative changes because it not only realigns the patella to take pressure off the lateral side, it also redistributes the forces proximal and distal to try to relieve some of the pressure on the worn area.
Usually the tibial tubercle
is taken as the fixed bony point, and the circumference of the thigh measured 9 in.
The examiner's hands are placed around the proximal tibia with the thumbs placed on the tibial tubercle
On physical examination, check for the quadriceps angle, or Q-angle, which is the angle created between a line drawn from the center of the anterior superior iliac spine on the pelvis to the center of the patella and a second line from the center of the patella to the middle of the tibial tubercle
For no reason, someone asks when anyone last saw a puppy with a tibial tubercle
Fairclough thought that the only alternative was a tibial tubercle
transfer - a major operation which involved moving the knee cap by literally breaking the tibia.
Pain and tenderness begin at the upper part of the tibia, just below the knee, where the large thigh muscle is attached by a tendon to a small, rounded bit of bone called the tibial tubercle
If strenuous activity is continued despite pain, the bony tibial tubercle
may become permanently enlarged and appear unslightly in females.
The proximal fracture site was at the tibial tubercle
and distal site at mid-tibial shaft (Fig.
Two potentiometers, placed on the patella and the tibial tubercle
respectively, were used to measure tibial displacement (millimetres).
The patella is constrained in the patellofemoral joint during the flexion cycle by a complex interplay between bony restraints and other primary stabilizers (ligamentous and bony anatomy of the knee), secondary stabilizers (such as the quadriceps musculature), position of the tibial tubercle
, and the overall coronal and rotational alignment of the lower extremity.