Distal realignment procedures are those surgical procedures performed below the kneecap in an attempt to better align it in the groove of the underlying femur bone.
Page updated january 2024 by Dr Sheila Strover (Clinical Editor)
Patellar instability
Distal realignment may be performed for recurrent patellar instability, such as recurrent subluxation or dislocation.
Relevance of the TT-TG distance
To assess how far the tibial tubercle and the trochlear groove are out of alignment, the surgeon will use scan pictures to calculate the TT-TG distance, and use this as a guide for correction.
The various distal realignment procedures
The various procedures have evolved over the years and include -
- Fulkerson procedure
- Maquet procedure
- Elmslie-Trillat procedure
- Hauser procedure
Quick links
Peer-reviewed papers
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Quote:
"....distomedial...tibial tubercle transfer....led to clinically relevant functional improvement and pain reduction in patients with patellar maltracking and patella alta without instability. However, the....[removal of hardware]....rate was high (72%)"
Citation: Bayoumi T, van Duijvenbode DC, Benner JL, Boerma-Argelo KDS, Stavenuiter MHJ, van der List JP. Clinical Improvement Is Achieved Following Tibial Tubercle Distomedialization for Patellar Maltracking and Patella Alta Without Instability. Arthrosc Sports Med Rehabil. 2021 Jun 15;3(3):e845-e853. doi: 10.1016/j.asmr.2021.01.027. PMID: 34195653; PMCID: PMC8220615.