Tibial Tubercle Transposition in the Treatment of Recurrent Patellofemoral Instability: A Report of Two Cases

Introduction: Recurrent patellofemoral instability is a frequent condition in young, active individuals. It results from anatomical and biomechanical factors such as trochlear dysplasia, an increased Q angle, or a lateralized tibial tubercle. Surgical treatment may involve tibial tubercle transposition (TTT) to realign the extensor apparatus and improve patellar tracking. Objective: To report the clinical and radiological outcomes of two patients treated with medial tibial tubercle transposition for recurrent patellar dislocations. Case Reports: Case 1: A 19-year-old female athlete with a 3-year history of recurrent right patellar dislocations. CT scan revealed a TT–TG (tibial tubercle–trochlear groove) distance of 24 mm. A medial tibial tubercle transposition using the Elmslie-Trillat technique was performed. Case 2: A 22-year-old male with bilateral subluxations and significant functional limitation. MRI showed type B trochlear dysplasia (Dejour classification) with a TT–TG distance of 22 mm. Anteromedial transposition combined with MPFL reconstruction was performed. Results: At 12 months postoperative, both patients showed clinical stability with significant improvement in Kujala scores (>85). No recurrence of dislocation was reported, and anterior knee pain had resolved. Conclusion: Tibial tubercle transposition is a reliable technique in the surgical management of recurrent patellar instability, particularly when TT–TG distance is increased. It may be combined with additional procedures depending on associated anatomical abnormalities.