The study aimed to compare the midterm outcomes of medialization and anteromedialization tibial tubercle osteotomies when used in the management of recurrent patellofemoral instability. The hypothesis is that both techniques would result in significant improvement for patellofemoral instability, but anteromedialization would result in a lower incidence of early osteoarthritis. In the cohort study, all skeletally mature patients aged 18 years old or younger who underwent tibial tubercle osteotomy for recurrent patellofemoral instability within a 10-year period in a single institution were included. All patients underwent either medialization or anteromedialization tibial tubercle osteotomy. The preoperative and postoperative outcomes of the tibial tubercle osteotomies were compared. All patients included in the study had a minimum of 5-year follow-up duration before the conclusion of the study. There was no statistically significant difference in the rates of preoperative and postoperative patellofemoral dislocation when either technique was employed (p = 0.999). Additionally, both the preoperative and postoperative Kujala scores were similar (p = 0.166 and p = 0.554, respectively). The knees did not have a statistically significant difference in their patellar tilt angles and tibial tubercle-trochlear groove distances preoperatively or postoperatively when either technique was used (p = 0.165 and 0.149, respectively). There was also no incidence of osteoarthritis identified in either of the groups (p = 0.999). Both anteriorization and anteromedialization tibial tubercle osteotomies were effective surgical management for patellofemoral instability when combined with medial patellofemoral ligament reconstruction. There were no significant differences in clinical, functional, and radiological outcomes when either medialization or anteromedialization tibial tubercle osteotomy was performed.

该研究旨在比较内侧和前内侧胫骨结节截骨术用于治疗复发性髌股不稳的中期结果。假设这两种技术都会显着改善髌股不稳定性，但前内侧化会降低早期骨关节炎的发生率。在队列研究中，纳入了所有在 10 年内因复发性髌股不稳而在同一机构接受胫骨结节截骨术的 18 岁或以下骨骼成熟患者。所有患者均接受内侧或前内侧胫骨结节截骨术。比较胫骨结节截骨术的术前和术后结果。研究结束前，所有参与研究的患者均接受了至少 5 年的随访。无论采用哪种技术，术前和术后髌股关节脱位率均无统计学差异（p  = 0.999）。此外，术前和术后 Kujala 评分相似（分别为p  = 0.166 和p  = 0.554）。使用这两种技术时，术前或术后膝盖的髌骨倾斜角度和胫骨结节-滑车沟距离没有统计学上的显着差异（分别为p  = 0.165 和 0.149）。两组均未发现骨关节炎发生率 ( p  = 0.999)。当与内侧髌股韧带重建相结合时，前前化和前内侧化胫骨结节截骨术都是治疗髌股不稳的有效手术治疗方法。当进行内侧或前内侧胫骨结节截骨术时，临床、功能和放射学结果没有显着差异。