Bartsch Anna, Atzmon Ran, Pierre Kinsley, Vel Monica S, Sherman Seth L
Department of Orthopaedic Surgery, School of Medicine, Stanford University, Redwood City, California, USA.
Department of Physical Medicine and Rehabilitation, School of Medicine, Stanford University, Redwood City, California, USA.
Video J Sports Med. 2024 Jun 13;4(3):26350254241227439. doi: 10.1177/26350254241227439. eCollection 2024 May-Jun.
Tibial tubercle osteotomy (TTO) can realign the patellofemoral joint and reduce patellofemoral contact stress. Anteriorization can reduce compressive patellofemoral loads and medialization shifts the pulling direction on the patella, thereby lowering the load on the lateral compartments.
Patellofemoral instability, patellofemoral malalignment, and distal and lateral chondral defects.
The Multi-Directional Tibial Tubercle Transfer System (MD3T) uses a generic 3-dimensional cutting template to create 2 compound wedges that are individually transposed and adjusted to achieve multiplanar correction. For isolated tibial tubercle , the primary wedge is solely used and the proximal bone defect is filled with autograft taken from the distal part of the wedge and synthetic bone graft substitution. For tibial tubercle , the primary and secondary wedges are transposed, filling each other's respective spaces. Through the transposition of the primary and secondary wedges, partial filling of the defect with the patient's own bone is achieved, reducing the bone defect. For combined , both of these techniques are merged.
During walking fatigue test and chair rising test in a cadaveric simulated 42-day healing period, no loosening or cracking occurred. Clinical study results on this technique are pending.
The MD3T system achieves with its wedge technique a precise and reproducible multiplanar correction in TTO.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
胫骨结节截骨术（TTO）可使髌股关节重新对线并降低髌股关节接触应力。前移可减少髌股关节的压缩负荷，而内移可改变髌骨上的牵拉方向，从而降低外侧间室的负荷。
髌股关节不稳定、髌股关节对线不良以及远端和外侧软骨缺损。
多向胫骨结节转移系统（MD3T）使用通用的三维切割模板创建两个复合楔形块，分别进行移位和调整以实现多平面矫正。对于孤立的胫骨结节，仅使用主楔形块，近端骨缺损用取自楔形块远端的自体骨和人工骨移植替代物填充。对于胫骨结节，主楔形块和次楔形块进行移位，相互填充各自的空间。通过主楔形块和次楔形块的移位，用患者自身的骨部分填充缺损，减少骨缺损。对于联合情况，将这两种技术合并。
在尸体模拟42天愈合期的步行疲劳试验和从椅子上起身试验中，未发生松动或开裂。关于该技术的临床研究结果尚待确定。
MD3T系统通过其楔形技术在胫骨结节截骨术中实现了精确且可重复的多平面矫正。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可被识别，作者已随本投稿附上患者的豁免声明或其他书面批准形式以供发表。
