从不稳定到过载：胫骨结节截骨术的三维与基于病情的策略
简介
这项遵循PRISMA的范围综述纳入14项研究，评估胫骨结节截骨术（TTO）的个体化规划策略、影像学阈值与结局。内移（TT-TG >12.5–20 mm）、远移（Caton-Deschamps ≥1.2–1.4）和前移（5–10 mm）的阈值差异较大，多数作者以术后恢复正常为目标而非普遍或最大程度矫正；5项研究按阈值选择比较了结局。证据支持针对具体畸形向量进行…
英文摘要
Tibial tubercle osteotomy (TTO) is a versatile realignment procedure used to address patellofemoral instability, maltracking, overload, chondral disease, and combined deformities. Modern approaches emphasize individualized, multiplanar correction based on detailed anatomic drivers. A scoping review was conducted following PRISMA guidelines to identify studies describing patient-specific planning strategies, imaging-based thresholds, and outcomes of TTO. Fourteen studies met the inclusion criteria. Thresholds for medialization (TT-TG >12.5 to 20 mm), distalization (Caton-Deschamps ≥1.2 to 1.4), and anteriorization (5 to 10 mm) varied, with most authors aiming for postoperative normalization rather than a general or maximal correction. Five studies compared outcomes by threshold selection. Evidence supports vector-specific correction to optimize patellar entry, tracking, and load distribution, though multiplanar planning remains heterogeneously applied. Individualized TTO planning relies heavily on 2D thresholds despite the multidimensional nature of patellofemoral pathology. Emerging 3D imaging and patient-specific techniques show promise, but validated protocols for selecting combined corrective vectors are still lacking.