TTT surgery, or tibial tubercle (or tuberosity) transfer, is a surgical procedure designed to realign the kneecap (patella) to improve its tracking within the groove at the end of the femur (thighbone). It involves repositioning the tibial tubercle, a bony prominence on the front of the shinbone (tibia) where the patellar tendon attaches.
How TTT Surgery Works
The procedure involves the following steps:
- Osteotomy: A surgeon carefully cuts a small piece of bone containing the tibial tubercle.
- Repositioning: The bone fragment with the tubercle is then moved to a new, more optimal position. The exact direction and amount of movement depends on the specific biomechanical issues causing the patellar maltracking.
- Fixation: Finally, the repositioned tubercle is secured to the tibia using screws and/or other fixation devices (like anchors) to allow the bone to heal in its corrected position.
Why is TTT Surgery Performed?
TTT surgery aims to correct patellar maltracking, which can lead to several problems, including:
- Patellofemoral Pain Syndrome: Pain in the front of the knee, often aggravated by activities like running, squatting, or climbing stairs.
- Recurrent Patellar Subluxation or Dislocation: The kneecap partially or fully dislocates from its groove.
- Cartilage Damage: Prolonged maltracking can lead to cartilage wear and tear within the knee joint, potentially leading to osteoarthritis.
When is TTT Surgery Recommended?
TTT surgery is typically considered when non-surgical treatments, such as physical therapy, bracing, and pain medication, have failed to provide adequate relief. It is usually reserved for patients with significant patellar maltracking and symptoms that severely limit their daily activities. Careful pre-operative planning and assessment are crucial to determine if TTT surgery is appropriate.
