Return to Sport after Tibial Tubercle Osteotomy for Patellofemoral Pain and Osteoarthritis


      Anteromedialization (AMZ) tibial tubercle osteotomy (TTO) is an effective treatment for moderate patellofemoral osteoarthritis, patellofemoral compression syndrome, and coronal malalignment in patellofemoral instability. There is limited literature regarding its capacity to reliably return patients to sports. The objective was to determine the rate of return to sport after AMZ TTO for patellofemoral pain or arthritis.


      This was a retrospective review of consecutive patients who underwent unilateral or bilateral AMZ TTO for patellofemoral pain or arthritis. All patients had minimum 1 year follow up. Final follow up consisted of an additional patient-reported questionnaire with questions regarding physical fitness and sporting activities and Kujala score.


      48 patients participated in sports within the 3 years prior to surgery. Average age at surgery was 29.6 years with an average follow-up of 4.6 years. Kujala pain score improved from 51.2 preoperatively to 82.6 postoperatively (p < 0.0001). 83.3% were able to return to at least 1 sport postoperatively, 62.5% were able to resume more than 1 sport, and 60.4% were able to return to 100% of the sports they participated in preoperatively. The average time to return to sport was 7.8 months (range, 3-19 months). Patients most commonly returned to weightlifting (16/17), cycling (11/12), soccer (7/8), elliptical (13/16), running (24/33), and yoga (6/8) (Figure). 77.5% who returned to sports felt that they returned at the same or a higher level compared to preoperatively. 77% felt that their physical fitness stayed the same or improved. 78.9% were satisfied to very satisfied with their surgical results.


      Patients undergoing AMZ TTO for patellofemoral pain or arthritis had an 83.3% rate of return to 1 or more sports at an average of 7.8 months after surgery, with many patients returning at the same or higher level of intensity compared to their preoperative state.