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Correlation of Patellar Articular Lesions with Results from Anteromedial Tibial Tubercle Transfer

Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut

Richard N. Weinstein, MD

Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut

David A. Buuck, MD

Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut

John P. Fulkerson, MD

Department of Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut

This retrospective study determined that the outcome from anteromedialization of the tibial tubercle corre lates well with the location of patellar articular lesions. Detailed descriptions of patellar articular cartilage le sions were obtained from the operative reports of 36 patients who had anteromedialization performed be tween February 1984 and March 1994. The patterns fell into four distinct groups. Ten patients with type I (distal) patellar lesions and 13 patients with type II (lateral facet) patellar lesions had 87% good to excel lent subjective results, and 100% of these patients said they would have the procedure done again. Nine pa tients with type III (medial facet) lesions had 55% good to excellent results, and 5 patients with type IV (prox imal or diffuse) lesions had only 20% good to excellent results. Patients with type I or II lesions were signifi cantly more likely to have good or excellent results than those with type III or IV lesions. Central trochlear lesions were associated with medial patellar lesions and all patients with central trochlear lesions had poor results. There was no significant correlation between the Outerbridge grading of the patellar lesion and the overall results. Workers' compensation issues dimin ished the likelihood of a satisfactory outcome by 19%; however, this was not statistically significant. This is the first study to correlate the patellar articular cartilage lesion with outcome after tibial tubercle transfer.

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