Preparing for Your Tibial Tubercle Osteotomy
01A Message From Dr. Pettit
Thank you for the opportunity to take part in your care. Our number one goal, along with our team at Beacon Orthopaedics and Sports Medicine, is to improve your quality of life through our knowledge, skill, experience, and — most importantly — compassionate care. Tibial Tubercle Osteotomy is a highly effective procedure, but we recognize that surgery can be stressful, and we hope to make this process as smooth as possible.
This guide is a resource to help you and your loved ones understand your tibial tubercle osteotomy, prepare for the day of surgery, and know what to expect during your recovery. Please keep it with you up to your date of surgery and beyond. Our team is always here to answer your questions — please do not hesitate to contact us about anything.
Robert J. Pettit, MD
02About Your Tibial Tubercle Osteotomy
A tibial tubercle osteotomy repositions the bony bump where the kneecap tendon attaches to the shin, changing how the kneecap tracks. It is used for kneecap instability or to offload a worn area behind the kneecap, and is often combined with a ligament reconstruction (MPFL).
Tibial tubercle osteotomy repositions the bony attachment of the patellar tendon on the tibia to improve kneecap tracking and reduce excessive pressure on the cartilage under the kneecap.
Want to see how the procedure is done? Watch an animation and read more at Orthopedia patient education.
03Is This the Right Procedure for You?
Why it may be recommended
- Recurrent patellar instability with significant malalignment
- Patellofemoral cartilage damage related to poor tracking
- Cases not adequately addressed by soft-tissue procedures alone
What it is intended to achieve
- Directly corrects the bony alignment contributing to instability or cartilage overload
- Can meaningfully reduce patellofemoral pain and instability
- Often combined with other stabilizing procedures for a comprehensive correction
04Risks to Understand
Risks include infection, blood clot, delayed bone healing, hardware irritation, and fracture at the osteotomy site. Dr. Pettit will explain the specific correction planned for your anatomy.
05In the Weeks Before Surgery
- Complete your pre-operative clearance. Depending on your age and health, you may need lab work, an EKG, or a visit with your primary care doctor or cardiologist. Our surgery scheduler will tell you exactly what is required
- Review your medications with us. Blood thinners (such as warfarin, Eliquis, Xarelto, Plavix, or aspirin) and certain supplements may need to be stopped before surgery
- but never stop a prescribed medication without instruction from the prescribing doctor
- Stop nicotine. Smoking and vaping slow healing. Stopping even a few weeks before surgery improves your recovery
- this is especially important for tendon, ligament, cartilage, and bone healing
- Arrange a ride and a helper. You cannot drive yourself home after anesthesia. Plan for a responsible adult to drive you and to stay with you the first night
- Prepare your home. Set up a comfortable recovery area with everything within reach, clear tripping hazards and loose rugs, and stock easy meals. If you will use crutches, a walker, a sling, or a brace, practice with it ahead of time
- Fill prescriptions early. If Dr. Pettit sends pain medication or other prescriptions before surgery, fill them ahead of time so they are ready when you get home.
- Complete pre-operative clearance, labs, and alignment imaging
- Stop NSAIDs and blood thinners as directed
- Arrange help at home for the first several weeks
- Follow fasting instructions before surgery
06The Day of Surgery
Sandy Evans, our surgery scheduler, will give you your exact arrival time and location, and will tell you when to stop eating and drinking — generally nothing to eat or drink after midnight the night before, unless you are told otherwise. Take only the medications we tell you to take, with a small sip of water. Leave jewelry and valuables at home, wear loose, comfortable clothing, and bring your photo ID, insurance card, and this guide. Most of our procedures are outpatient, meaning you go home the same day. You will meet the anesthesia team before your procedure to review your anesthesia plan and answer any questions.
07What to Expect After Surgery
- You will go home in a brace (often locked straight) and on crutches, with protected weight-bearing while the bone heals
- Physical therapy restores motion gradually and protects the kneecap while the bone unites
- Return to sport is typically several months, once bone healing and strength allow
- Follow protected weight-bearing instructions closely
- Use a brace and crutches as directed
- Elevate and ice the leg regularly
- Attend follow-up X-rays to monitor bone healing
Recovery timeline
- Weeks 0–6: protected, limited weight-bearing
- Weeks 6–12: progressive weight-bearing and motion
- Months 4–6: strengthening
- Months 6–9: return to sport, guided by strength and bone healing
08Post-Op Quick Reference
Keep this section for after your surgery. These highlights are drawn from Dr. Pettit's Tibial Tubercle Osteotomy post-operative protocol — your procedure may use a different variant, so always follow the copy you receive at surgery.
Medication management
You have been given a regional anesthetic block prior to your operation; this will wear off in the evening following your surgery. We recommend taking pain medication once you feel the block wearing off. You may find it beneficial to sleep in a recliner or propped up with pillows in the days following surgery.
- DO NOT drive/use any heavy machinery, drink alcohol, make any life-changing or legal decisions (i.e. sign a will), or participate in activities that require a lot of physical skill, as narcotics may change your mental acuity. On rare occasions they may cause confusion or disorientation, we advise you to discontinue this medication should that occur.
- Narcotics can be addictive. Dispose of any excess medication at a police/fire station.
- Take a stool softener (e.g. Colace) while taking narcotic medication, as narcotics may cause constipation. If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please call our office if this regimen does not alleviate your constipation.
- If you have any questions or concerns about narcotic strength medications, please contact us.
Tylenol and Celebrex/Ibuprofen are the foundation for your pain control regimen. Example dosing: 1000mg Tylenol then 4 hours later 800mg Ibuprofen then 4 hours later repeat — every 4 hours alternate between Tylenol and Ibuprofen. Oxycodone as needed for breakthrough pain. *You should not exceed 3,000mg of Tylenol or 3,200mg of Ibuprofen in 24 hours.
Crutches & Weight Bearing Status
- Following a Tibial Tubercle Osteotomy, you will be heel touch (gently place the foot down) for 6 weeks. Keep the Brace locked in extension while heel touch weight bearing
Follow-up appointment
- Your first post-operative appointment will be scheduled 10 – 14 days following your surgical procedure. Typically dissolvable sutures are used during surgery, and do not need to be removed. If you do not have a post-operative appointment scheduled when you leave following surgery, please call 513-441-5639 to make the appointment. ***
Call 911 and go to the nearest hospital if you are having chest pain or trouble breathing.
Call the office at 513-354-3700 to report any of the following:
- Persistent fever (101 or greater)
- Sudden increase in pain and swelling
- Wound redness or drainage (besides blood)
- Increased skin temperature around incision
- Deep calf pain and swelling
- Severe abdominal pain
09Common Questions
10Questions & Scheduling
Once you and Dr. Pettit decide on surgery, Sandy Evans, our surgery scheduler, will handle your surgery date, insurance authorization, pre-operative clearances, and exact arrival instructions. Maria Dodd, PA-C helps manage your recovery — medications, imaging, and questions — throughout.
Surgery scheduling & direct office line: (513) 441-5639 · Main office: (513) 354-3700
