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Tibial Tubercle Osteotomy

Medically reviewed by Last updated on Jan 5, 2023.

What do I need to know about tibial tubercle osteotomy (TTO)?

TTO is surgery to place your patella (knee cap) in the correct position. Your surgeon will line your knee cap up with your thigh and shin. This may relieve pain and improve movement of your leg.

How do I prepare for TTO?

  • Your provider will talk to you about how to prepare for surgery. You may need x-rays or a CT scan. This will help your provider plan for your surgery. Do not eat or drink anything after midnight on the day of your surgery. Your provider will tell you what medicines to take or not take on the day of your surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection.
  • Arrange for someone to drive you home after your surgery. Do not drive yourself home.

What will happen during TTO?

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given spinal anesthesia to numb the surgery area. With spinal anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain.
  • Your provider will make an incision in your skin right under your knee cap. He or she will make a cut at the top of your shin bone. He or she will place your knee cap in the correct position. He or she may use hardware such as screws or a wire to hold your knee cap in place. He or she will close the incision with stitches and cover it with a bandage. You may also have a knee immobilizer on your leg to prevent movement.

What will happen after TTO?

You may need to wear your knee immobilizer at all times except when you are sleeping. You may be given crutches, a cane, or a walker to keep weight off your leg. A physical therapist may teach you exercises to help improve movement and strength, and to decrease pain. He or she may also teach you how to use your crutches. You may receive a continuous passive motion machine (CPM). The CPM helps gently move your knee to prevent stiffness.

What are the risks of TTO?

Your incision may take longer to heal, or not heal correctly. Your shin bone may break during the surgery. Nerves, blood vessels, ligaments, or muscles may be damaged. Your joint may become stiff, numb, and more painful. Your joint movement may not be the same as it was before. You may need more surgery to remove the hardware placed in your shin bone. You may get an infection or bleed more than expected. You may get a blood clot in your leg. This may become life-threatening.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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