PMC4957172_01
(a) Preoperative weight-bearing anteroposterior radiograph of the bilateral knees. The left knee is noted to have significant degenerative changes. (b) Preoperative lateral radiograph demonstrates patella alta. (c) Preoperative Merchant views show significant posttraumatic deformity of the left patella.
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Radiographs revealed an anatomic valgus alignment of 7  and patella alta secondary to her chronic extensor mechanism insufficiency (Fig. 1a, b, and c).
Intraoperative fluoroscopic image demonstrating advancement of the tibial tubercle with screw fixation.
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Fluoroscopy was used to assess the osteotomy site and confirm the acceptable patellar position (Fig. 2), and tracking was central without subluxation or excessive tilt.
(a) Final postoperative radiographs demonstrate excellent coronal alignment with no evidence of osteolysis or loosening. (b) Final follow-up postoperative radiograph demonstrating no evidence of loosening and complete healing of the tibial tubercle osteotomy. (c) Final follow-up Merchant views show excellent tracking of the native patella in the trochlear groove of the femoral component.
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Radiographs revealed excellent coronal plane alignment, healed tibial tubercle osteotomy, and central patellar tracking (Fig. 3a, b, and c).