Learning About a Tibial Tuberosity Transfer Surgery

Good news and bad news...  I met with my orthopedic surgeon today to review my MRI results of my knee.  The good news is that there is no evidence of any kind of a tear.  The bad news is that the only problem found (in addition to swelling and inflammation) is what we already knew--the tendon connecting my kneecap to my shin is offset.  My patellar tendon angle measures about 19 degrees laterally, causing my kneecap to be pulled laterally in its groove, causing pain and wearing down my cartilage.  The doctor explained the surgery to correct this, called a tibial tuberosity transfer, which involves drilling to detach the part of my shin bone that the tendon attaches to and moving that bone medially on my shin and securing it with some screws.  The recovery is long and difficult.

This isn't my knee, but this is a picture of the problem that I have with my patellar tendon being offset. The black line following the patellar tendon below the kneecap should be aligned with the femur.

This shows what the tibial tuberosity transfer surgery does to straighten out the patellar tendon, by cutting out the piece of bone that the tendon attaches to and moving it to correct the offset angle and better keep the kneecap in its groove.

The doctor suggested we move ahead with surgery until we mentioned that we have a daughter with severe disabilities that requires us to lift and transfer her.  Because of that, the doctor has suggested that we put off surgery as long as possible--until I'm more disabled myself, he said--since the surgery would make caring for Annie completely impossible for several months.

So the plan now is to have me take more prescription anti-inflammatories for a couple months to try to get the inflammation under control.  I'm trying a new medication this time that hopefully won't cause such severe ulcers like the last one.

Along with the new medication, I'll continue my twice-daily physical therapy, and as pain allows, gradually progress to more exercises that will help strengthen my knee with the hopes that correcting any muscle imbalances will help keep the kneecap in its proper groove.

If the anti-inflammatories and physical therapy don't bring any improvement after a few months, the doctor will give me some steroid injections in my knee to target the inflammation even more.

I don't hope to ever run a marathon or even go jogging for that matter... I just hope to be able to go up and down stairs without pain and be able to squat down on the floor to play with my kids.  Hopefully I can resume my regular daily activities after a few months of this new medication and continued physical therapy, and avoid such a difficult surgery.  ...Although it has been very nice to have Justin helping me so much with house cleaning and other tasks I've been unable to perform for the past 4 months!