Tibial tuberosity derotation: a surgical procedure for realignment of the patellofemoral mechanism

We retrospectively reviewed the clinical outcomes of 22 patients (9 men and 13 women) aged 17–42 years, and affected with anterior knee pain. These patients underwent surgical derotation of the tibial tuberosity in the period between September 1992 and December 1993. We describe the details of this new surgical technique to correct a torsional abnormality that has perhaps been underestimated in the past, as a possible cause of anterior knee pain. Follow-up clinical and radiographic controls (average follow-up, 78 months; range 72–87 months) allowed us to document the efficacy of this new procedure as a treatment for anterior knee pain resistant to conservative therapy, in young patients with external hypertorsion of the proximal tibial metaphysis and without significant chondropathology.