TTT TTO HTO AMZ

[Jwin138]

HI All,

I am hoping someone can help clarify the differnces between - TTT - TTO HTO and AMZ

I think the TTT is the same as the AMZ -

thanks for your input!!
Jess

[Jwin138]

-- and I beleive Fulkerson is the same as TTT and AMZ - that is done to correct alignment.

please clarfiy if you can! thanks!

[kate-emma]

Hey Jess

TTT and AMZ are the same thing in theory, though AMZ is more like TTT +1. TTT is the process of cutting free bone and moving it to restructure where your patella is in your kneecap (move it closer to your inside knee so the MPFL doesn't have as much work to do). AMZ adds to that by including a lateral release where keyhole surgery is used to cut your lateral retinaculum and loosen it (the lateral retinaculum is the one on the outside and if too strong it does in fact help pull your kneecap out). Together these two surgeries are called AMZ or anteromedialization.

TTO, better known as Fulkersons, means the same thing as TTT, it's merely a fancier way of saying it. TTO refers to the tibia (so lower in the knee) where HTO refers to higher in the knee. Both just indicate where the problem lies.

[KW]

TTT = Tibial tubercle transfer,  This is an overall general term for the procedure.  There are many specific versions of the TTT (Fulkerson, Maquet, Hauser, AMZ) which are generally named after the Dr or how the Tibial Tubercle is being moved.

TTO - Tibial tubercle osteotomy,  Same as a TTT.  The surgical procedure is a osteotomy.

Fulkerson - Is a version of a TTT/TTO.  Developed by Dr John Fulkerson.

AMZ - Anteromedialization is a version of a TTT but has nothing to do with combining with a lateral release.  It is named after how the tibial tubercle is moved.  "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."

HTO - High Tibial Osteotomy - Is a completely different kind of Osteotomy from a TTT.  A HTO will change the forces of the joint between the medial/lateral  due to meniscus loss or other damage in these compartments.  HTO has nothing to do with patella tracking.


This site does a OK job describing TTT's and some of the different versions.  BEWARE there are actual surgical photos.

http://patellamd.com/16.html


Hope this helps.