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High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis.Since the inception of the procedure, advancements to technique, fixation devices, and a better understanding of patient selection has allowed HTO to become more popular in younger, more active patients hoping to combat arthritis. [1]
The tibial tuberosity thus forms the terminal part of the large structure that acts as a lever to extend the knee-joint and prevents the knee from collapsing when the foot strikes the ground. [1] The two ligaments, the patella, and the tibial tuberosity are all superficial, easily palpable structures. [2]
[9] [4] One tibial section attaches to soft tissue, 1 cm distal to the joint line. The other tibial section attaches directly to the tibia, anterior to the posteromedial tibial crest, 6 cm distal to the joint line. [2] [9] This distal attachment is the stronger of the two and makes up the floor of the pes anserine bursa.
With the patient supine and the knees flexed 30° off the table, stabilize the thigh and externally rotate the foot. As the foot rotates, watch for external rotation of the tibial tubercle of the affected knee compared to the healthy one. A difference of greater than 10-15° indicates a positive test and likely injuries to the posterolateral knee.
The tibial plateau leveling osteotomy and tibial tuberosity advancement are two of the most common osteotomy procedures performed in the United States. Recovery is often 6–8 weeks and the osteotomy can be filled with autologous bone grafts, scaffolds (hydroxyapatite, TR Matrix, etc.) or ceramics. [14]
Similar calcification and ossification may be seen at peripheral entheseal sites, including the shoulder, iliac crest, ischial tuberosity, trochanters of the hip, tibial tuberosities, patellae, and bones of the hands and/or feet. [6] DISH can be a complicating factor when suffering from trauma involving the spine.
Apophysitis of the tibial tubercle, Lannelongue's disease, [1] osteochondrosis of the tibial tubercle [2] Lateral view X-ray of the knee demonstrating fragmentation of the tibial tubercle with overlying soft tissue swelling. Specialty: Orthopedics: Symptoms: Painful bump just below the knee, worse with activity and better with rest [3] Usual onset
The PCL is located within the knee joint where it stabilizes the articulating bones, particularly the femur and the tibia, during movement.It originates from the lateral edge of the medial femoral condyle and the roof of the intercondyle notch [5] then stretches, at a posterior and lateral angle, toward the posterior of the tibia just below its articular surface.