Elmslie Trillat Procedure

This is one of a number of procedures known as 'distal realignment procedures', in which the kneecap is effectively repositioned by re-aligning the attachment of the patellar tendon (the tendon under the kneecap) to the underlying tibial tubercle. Also known as TTT or tibial tubercle transfer procedures.

These operations are done to prevent the kneecap going too far over to one side (subluxation) or jumping completely out of its groove (dislocation).

Proximal realignment procedures tackle the problem by adjusting the structures above the kneecap, rather than below it.

In the Elmslie Trillat procedure the tibial tubercle, which you can feel as the knob an inch or two below the lower edge of the kneecap, is cut and moved towards the medial (inner) side. The original procedure is more often these days replaced by the modified procedure called the Elmslie-Trillat-Maquet procedure.

As many know I have had knee problems all my life. Within the last few years my knees have been bugging me and I found out that my knees were wearing. The knees were actually grinding down the knee joint area in my knees that lead to me having Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopaedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction, and trimming damaged cartilage. This procedure was performed twice on the right knee and once on the left knee.

Once again my right knee was really bugging me and started to get inflamed and swell after a day's activites. So I went in to have it checked out. The X-Ray showed this.

As you can see on the left image my knee cap is off center and moved to the side. The second image shows in yellow where the knee cap should be.

So I decided that I should get the surgery done.

After the surgery you can see my knee cap is placed back to where it should be.

To get the knee cap where it needed to be I had the Elmslie Trillat Procedure whcih basically the doctor drilled some holes into my leg bone and with a hammer and chisel cracked (broke) the bone off. Then the knee and bone was repositioned and screwed into place with two titanium screws. As my knee was open the doctor also placed in some resin type material to fill in the area where my knee joint area was rubbing thin, this materail acts like new cartilage.


Two weeks afater the procedure the stitches were removed. It was moist and not really healed. So on the wound itself the doctor placed on some silver nitrate which acts like a chemical burn to hold the wound closed. So for the next few days physical therapy is on hold so I do not rip open the wound. I have to let the area air out and hopefully dry so it can heal.

This is what the would looks like.

After the wound healed I am back on track. As of October 2009 my knee is healing well and I am on the road to recovery.