Anterior tibial tubercle osteotomy using cerclage wire fixation in total knee replacement: a modification of the usual technique

Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system. A retrospective review was performed on the surgical revision of total knee replacement cases intervened in our center that required an ATT osteotomy from February 2014 to February 2015, and who had a minimum clinical follow-up of 12 months. In all cases, there was an average proximal increase in ATT of 5 mm and, however, did not result in any loss of knee extension. All the osteotomies achieved complete bone consolidation at 3 months. There were no other complications. Our technique may be a valid option as it shows satisfactory results and demonstrates that a small increase in ATT does not affect the final clinical outcome.