Computational simulation of medial versus anteromedial tibial tuberosity transfer for patellar instability.

摘要: The study utilizes dynamic simulation of knee function to determine how tibial tuberosity medialization and anteromedialization influence patellar tracking contact pressures for knees with instability. Dual limb squatting was simulated six multibody models representing being treated Each exhibited lateral maltracking in the pre-operative condition based on bisect offset index. tendon attachment points tibia were medialized by 10 mm represent medialization, an additional 5 mm anteriorization applied anteromedialization. patellofemoral pressure distribution quantified using discrete element analysis. Data analyzed repeated measures analysis variance post-hoc tests linear regressions. Tibial significantly (p < 0.05) decreased index nearly all flexion angles up 80°, largest changes near full extension. Both procedures maximum at 55°, but increased medial from 30 80°. post-operative increase correlated (r2  = 0.84), not Statement Clinical Significance: results indicate decreases pressures, increases pressures. When is relatively low, likely lowers risk elevated compared medialization. © 2018 Orthopaedic Research Society. Published Wiley Periodicals, Inc. J Orthop Res 36:3231-3238, 2018.