{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:23:32Z","timestamp":1783488212972,"version":"3.55.0"},"reference-count":21,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T00:00:00Z","timestamp":1655164800000},"content-version":"vor","delay-in-days":164,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2022,5,13]]},"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>: Patella instability post total knee arthroplasty (TKA) is a rare complication. Tibial tubercle osteotomy (TTO) with medial patellofemoral ligament reconstruction (MPFLr) has not been well described for this indication. This paper describes a surgical technique to address the unique challenges faced when performing TTO and MPFLr in the prosthetic knee. <jats:italic>Technique<\/jats:italic>: This technique and video describe a TTO and MPFLr via an extensile incision and medial sub-vastus approach. A 6\u00a0cm long TTO is performed, if indicated, to medialise the extensor mechanism up to 1\u00a0cm and fixed with \u00d72 4.5\u00a0mm cortical screws. For the MPFLr, a quadriceps tendon autograft is utilized, with the natural insertion to the superior pole of the patella being left undisturbed. The graft is first attached with an interference screw and then reinforced with an endobutton to provide crucial cortical fixation to overcome the problem of low bone mineral density encountered in this area of the femur following TKA. <jats:italic>Results<\/jats:italic>: Five patients underwent MPFLr using the described technique. No failures or recurrence of instability occurred at the last follow-up. Pre-operative mean patella tilt and shift were 44\u00b0 and 3.5\u00a0cm, respectively. Post-operatively, mean tilt and shift were 4.1\u00b0 and 0.4\u00a0cm, respectively. There was one wound dehiscence requiring surgical debridement and closure. <jats:italic>Conclusion<\/jats:italic>: This paper describes a surgical technique to perform a TTO and MPFLr for patella instability post-TKA. The described method highlights key adaptations to address the unique challenges in this patient population.<\/jats:p>","DOI":"10.1051\/sicotj\/2022023","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T07:55:02Z","timestamp":1655193302000},"page":"23","source":"Crossref","is-referenced-by-count":6,"title":["Tibial tuberosity osteotomy and medial patellofemoral ligament reconstruction for patella dislocation following total knee arthroplasty: A double fixation technique"],"prefix":"10.1051","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3073-2416","authenticated-orcid":false,"given":"Jobe","family":"Shatrov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Colas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaspard","family":"Fournier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Batailler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvire","family":"Servien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Lustig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2022,6,14]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/01.blo.0000214415.83593.db","volume":"446","author":"Eisenhuth","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"7","key":"R2","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/S0883-5403(98)90026-2","volume":"13","author":"Harwin","year":"1998","journal-title":"J Arthroplasty"},{"key":"R3","doi-asserted-by":"crossref","first-page":"198","DOI":"10.2174\/1874325001509010198","volume":"9","author":"Astur","year":"2015","journal-title":"Open Orthop J"},{"issue":"11","key":"R4","doi-asserted-by":"crossref","first-page":"3513","DOI":"10.1007\/s00167-019-05447-w","volume":"27","author":"Bouras","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"7","key":"R5","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/s00167-005-0641-x","volume":"13","author":"Deie","year":"2005","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"6","key":"R6","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1177\/0363546519838405","volume":"47","author":"Sappey-Marinier","year":"2019","journal-title":"Am J Sports Med"},{"issue":"9","key":"R7","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.2106\/00004623-200709000-00016","volume":"89","author":"LaPrade","year":"2007","journal-title":"J Bone Joint Surg Am"},{"issue":"1S","key":"R8","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.otsr.2018.04.028","volume":"105","author":"Putman","year":"2019","journal-title":"Orthop Traumatol Surg Res"},{"issue":"6","key":"R9","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s00402-020-03468-6","volume":"140","author":"Warschawski","year":"2020","journal-title":"Arch Orthop Trauma Surg"},{"issue":"8","key":"R10","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1007\/s00590-019-02499-z","volume":"29","author":"Assiotis","year":"2019","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"3","key":"R11","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/230949900901700322","volume":"17","author":"Motsis","year":"2009","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"R12","unstructured":"Registry ANJ (2019) Australia National Joint Registry Report: 2019. 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