Ostectomy of the patellar groove just cranially to the insertion of the tendon of the long digital extensor creates a broad, well perfused cancellous bone bed onto which the base plate is secured by titanium bone screws. The groove component is then attached to the base plate by means of 3 conical pegs fitted into receiving conical holes. The broad area of the ostectomy of the patellar groove allows for considerable freedom in medial-lateral positioning of the base plate that can be used to improve quadriceps-to-patellar tendon alignment, thus avoiding conventional tibial tuberosity transposition. Use of trial implants during surgery aids the search for an optimal position of the final implant
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Functional loading of the implant leads to compression of its interface to the bone, which is mechanically favourable to the ill-conditioned load transfer called for by conventional tuberosity transposition, where the full force of the patellar tendon is transferred to the tibia by pins and a figure eight wire.
Significant angular deformities can be treated by concurrent corrective osteotomies in addition to patellar groove replacement, should the condition of the patello-femoral joint call for it. The same is true for cruciate ligament ruptures that can be concurrently treated by, for example, Tibial Tuberosity Advancement (TTA).
Post-surgical recovery is rapid and, at this time, no signs of implant loosening have been observed. The procedure presents relatively low morbidity and is meeting the expectations of the early adopters in terms of clinical improvement.
Patellar Groove Replacement implants and instruments were product by TWLIYMED, with optimal selection of materials and manufacturing techniques for precision, durability, and maintenance.
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