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The Effect of a Tibial-Tubercle Transplant in Children on the Growth of the Upper Tibial Epiphysis.

Fielding, J. William; Liebler, William A.; Tambakis, A.
Journal of Bone & Joint Surgery - American Volume: December 1960
Archive: PDF Only

Distal and medial transplantation of the tibial tubercle was performed twenty-four times in fifteen children who were in their eleventh year or younger.

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A follow-up study two to eleven years after operation revealed the following data:

The distally displaced patella, with but minor variations, tended to remain in the same position relative to the knee joint as growth continued; the articular surface of the transplanted patella showed some evidence of being remodeled to conform to the shape of the articular surfaces of the underlying femur and tibia;

The tibial tubercle failed to develop in either the normal or transplanted positions;

The attachment of the patellar tendon remained in its normal position as growth continued, migrating upward as the tibia increased in length; there was no evidence that the patellar tendon lengthened, except to the extent expected with normal growth;

With growth in length of the tibia, the epiphysis and metaphysis moved away from the plate and screws that had been used to fix the transplanted tibial tubercle. As a result, the plate and screws were found to be located on the diaphysis at follow-up;

With the technique employed, disturbance of growth of the proximal end of the tibia occurred in only one case-that in which a recurvatum deformity of sufficient severity developed to require corrective osteotomy;

The growth and development of the proximal tibial epiphysis and knee joint were not affected in any of the patients in these cases.

Copyright 1960 by The Journal of Bone and Joint Surgery, Incorporated

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