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What is TTT?

A tibial tubercle transfer (also known as a Fulkerson Osteotomy or anteriormedialization osteotomy) is a surgical procedure that is used to correct patellar instability and/or patellar malalignment.

Your surgeon will evaluate the necessity of performing a TTT based on your physical exam and anatomic measurements as determined by your exam and imaging. The TTT is a powerful tool to realign the patella with respect to the trochlear groove and help it track more centrally.

The procedure consists of an incision, which is made a few centimeters below the patella (kneecap) along the top portion of the shin bone (tibia). The patella is embedded in a tendon that inserts on a bony prominence at the shin bone, known as the tibial tuberosity. The patella is repositioned by surgically cutting the tibial tubercle and shifting it toward the inside of your knee and then reattaching it with screws. In certain cases it can be moved inferiorly as well.

How long will I stay in the hospital?

Most patients can go home the same day as their surgery. Occasionally, patients will stay overnight if they need additional assistance with pain management.

What are the possible risks and complications of surgery?

As with any surgery there is a risk of DVT (blood clot), nerve damage, and postoperative infection. Specific risks and complications include but aren’t limited to failure to heal, fracture, and hardware complications.

When can I drive?

You may not drive while taking pain medication.  In addition, if it is your right knee that had surgery, you will not be able to drive for approximately 6 weeks after surgery or until the brace is removed. You must have approval from your surgeon before starting to drive after surgery.

When can I resume jogging?

You will not resume jogging until cleared by your physician.  This typically is around 6 months after surgery. You will be allowed to begin biking without resistance once you have adequate range of motion and will begin this with your physical therapist.  Once adequate quad strength is demonstrated you will transition to the Elliptical, then running is the next step after that. It is essential that you have restoration of your strength before attempting to run in order to not cause damage to other areas of your knee.

When can I return to my sport?

There are many factors in determining when you will be ready to return to sport after surgery. Most patients are able to return around 7-10 months after surgery but it is essential that you are cleared by your surgeon and physical therapist before returning. Please see Physical Therapy for more information on this condition.