Tibial tubercle osteotomy for patello-femoral joint disorders.

Tibial tubercle osteotomy has a long history in the management of patella instability and patello-femoral arthritis. This review aims to provide a comprehensive review of the literature describing the biomechanics of the patello-femoral joint and the rationale behind the use of the tibial tubercle osteotomy in modern day practice. Several different tibial tubercle osteotomies are available and we aim to detail the concepts behind their use and the subsequent clinical results. With continued developments of chondrocyte implantation techniques, the potential to fill defects on the chondral surface of either the patella or trochlea in conjunction with a tibial tubercle osteotomy may well become more commonplace in a group that is commonly young and difficult to manage. Level of evidence III.Accepted manuscript (12 month embargo

Lower extremity growth and deformity

The pediatric lower extremity has well known growth patterns. When deformities or growth disturbances occur, there are several methods to measure and predict the resulting discrepancy, including the Green-Anderson, Moseley, and Multiplier methods. Many techniques exist to correct leg length discrepancy and deformity such and temporary epiphysiodesis, permanent epiphysiodesis, external fixators, and internal lengthening devices. All of these methods have numerous complications and limitations; however, with careful planning and patient selection, length and alignment can be improved with high patient satisfaction