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Despite being the most common surgical treatment option for patella alta, tibial tubercle osteotomy with distalization raises concerns due to the complete detachment of the tubercle, which may lead to damage of local vascularity from periosteal detachment and increased mechanical stress at the attachment site. These factors are related to greater risk of complications, such as fractures, loss of fixation, delayed union, or nonunion of the tuberosity. We describe a technique for tibial tubercle osteotomy with distalization that aims to minimize these complications through care with the osteotomy, stabilization, bone cut thickness, and local periosteum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Technique Video<\/jats:title>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"video\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:22126287:media:atn2bf00423:atn2bf00423-vimg-mmc2\">\n                          <jats:alt-text>video<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>See video under supplementary data.<\/jats:bold>\n                    <\/jats:p>\n                  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