Anteromedialization of the Tibial Tubercle for Treatment of Patellofemoral Malpositioning and Concomitant Isolated Patellofemoral Arthrosis

Summary: The surgical treatment of isolated patellofemoral arthritis has included surgical debridement, proximal soft-tissue balancing, joint-surface replacement, and a variety of local and distal osteotomies. The tibial tubercle osteotomies (for arthritis) have in common a component of tibial tubercle elevation. Anterior medialization (AMZ) of the tibial tubercle allows both elevation of the tibial tubercle and, at the same time, medial translation of the tubercle to effect centralization of patellar-tracking alignment. The original procedure, described by Dr. John Fulkerson, used largely freehand techniques. Through the use of a new intraoperative planning guide and captured saw cutting-block specific for the AMZ procedure, reliable osteotomy planes may be achieved early in the learning curve.