Osteochondrosis of the tibial tuberosity
(Osgood-Schlatter disease) and osteochondrosis of the patella (Sinding-Larsen-Johansson syndrome) occur at tendinous insertions into the patella at the distal and proximal levels, respectively.
The joint was stabilized with nylon suture (2-0 Ethilon; Ethicon) passed craniocaudally through holes drilled in the lateral femoral condyle and the tibial tuberosity
. The stifle was maintained in flexion during the suture placement, and, once stabilized, it could not be manually reluxated.
Chronic OSD carries the risk of long-term problems due to the formation of painful, nonunited ossicles resulting from fragmentation of the tibial tuberosity
. Because of this risk, Dr.
The pain is usually gone within a year, although it may last until the tibial tuberosity
fuses with the shaft of the tibia at about age 18.
Another tension band wire was passed through the neutralization hole made just posterior to the tibial tuberosity
and the retinaculum was repaired.
Whereas OWHTO undertaken below the tibial tuberosity
is one option to mitigate the risk of patella infera, this technique has the disadvantage of cortical bone involvement and slow healing rate .
Many studies have investigated several reference points both in the proximal tibial and distal limb, including the tibial tuberosity
, intercondylar eminence, intermalleolar distance, second metatarsal, dorsalis pedis artery, and extensor hallucis longus.[sup],,, Errors in the placement of the extramedullary tibial rod may be introduced by multiple factors and mainly occur at the distal tibia and ankle joint.
A 2009 study pointed to tibial tuberosity--the protrusion on the front of the tibia to which tendons attach, suggesting that the narrower the tibial tuberosity
, the greater risk of ligament rupture.
Shaft fractures within 4 cms distal to the tibial tuberosity
to 4 cms proximal to the ankle joint in tibia, in which the medullary canal was large enough to accept a minimum 8 mm nail.
Bone marrow aspiration procedure was done from posterior superior iliac spine in patients older than one year while tibial tuberosity
was used in patients less than one year of age.
The Q angle refers to the angle subtended by lines drawn from the anterior superior iliac spine to the center of the patella and another line drawn from the center of the patella to the tibial tuberosity
. The Q angle in females (15[degrees] to 20[degrees]) is typically larger than that of males (8[degrees] to 15[degrees]), which may help explain why patellofemoral instability is more common in females.
Entre las tecnicas de osteotomia correctiva se encuentran el avance de la tuberosidad tibial (Tibial Tuberosity
Advancement), osteotomia tibial en cuna (Tibial Wedge Osteotomy), osteotomia tibial triple (Triple tibial osteotomy) y la TPLO (17).