Why is tibial tubercle osteotomy (Fulkerson procedure) necessary for recurrent patellar dislocation with patella alta or excessive TT-TG distance?

Doctor’s answer

Isolated MPFL reconstruction only addresses soft tissue ligament laxity. If CT shows a tibial tubercle-trochlear groove distance (TT-TG) >20mm, severe patella alta (Caton-Deschamps index >1.2), or significant lateral bony malalignment, excessive lateral force can cause soft tissue grafts to stretch and rupture again. In such cases, combining tibial tubercle medialization/distalization osteotomy (Fulkerson) can correct the quadriceps pull line from a bony geometric perspective, thoroughly stabilizing the patellofemoral joint.

This content is for education. Diagnosis, treatment, and rehabilitation require an individual assessment by a sports medicine specialist.