Tibial Tuberosity Osteotomy: Indications, Techniques, and Outcomes

Am J Sports Med. 2014 Aug;42(8):2006-17. doi: 10.1177/0363546513507423. Epub 2013 Nov 6.


Tibial tuberosity osteotomy (TTO) is a well-described treatment option for a broad range of patellofemoral joint disorders, including patellofemoral instability, patellar and trochlear focal chondral lesions, and patellofemoral arthritis. The purpose of this article is to review the evolution of the TTO procedure, from the original Hauser procedure to the current anteromedialization procedure, as well as discuss the pertinent anatomy and radiographs that accompany this procedure. The article highlights the surgical techniques for some of the more commonly performed TTO procedures and discusses the outcomes of the various TTO techniques. Complications, as well as clinical pearls to avoid these complications, are also included.

Keywords: biomechanics; instability; knee; patellar tendon; patellofemoral; surgical management; tibial tubercle; tibial tuberosity osteotomy.

Publication types

  • Review

MeSH terms

  • Biomechanical Phenomena
  • Connective Tissue / physiology
  • Connective Tissue / physiopathology
  • Humans
  • Osteotomy / adverse effects
  • Osteotomy / methods*
  • Patella / surgery
  • Patellofemoral Joint / physiology
  • Patellofemoral Joint / physiopathology
  • Patellofemoral Joint / surgery*
  • Tibia / surgery*
  • Treatment Outcome