Anterior advancement of the tibial tuberosity in the treatment of the patellofemoral pain syndrome.

Seventy-two patients with disabling patellofemoral pain were treated with anterior advancement of the tibial tuberosity. In a follow-up examination 1-5 years (mean 2.5) postoperatively, 57% of the patients had improved, 19% were unchanged, and 24% were worse. The high failure rate is disturbing, and we warn against too frequent use of the anterior tuberosity advancement procedure. Patients with patellofemoral pain should be approached by establishing a specific diagnosis and applying a specific treatment. In this study we concluded that the only patients who might benefit from the operation were those with grade I-II changes of the patellar cartilage.