John Fulkerson (@Patelladoc) header
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Professor of Orthopedic Surgery at Yale- love 3D imaging in trochlea dysplasia

New Haven, Connecticut, USA
Joined March 2013
Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)Photo by John Fulkerson (@Patelladoc)
John Fulkerson retweeted
ABC. A lot Better for the Cartilage AMTTO preserves the joint long term and avoids metal/plastic
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John Fulkerson retweeted
If the patella is unstable and tracks laterally or with a J, move it to be stable. Leave the trochlear cartilage alone
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John Fulkerson retweeted
Is as simple as this if the patella is lateral and dislocated, anteromedial TTO with a little distalization gets the patella safely inside the lateral convexity, raises the patella past the spur and unloads. Just rebuild the MPFC to further stabilize. Rarely need trochleoplasty
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ABC. A lot Better for the Cartilage AMTTO preserves the joint long term and avoids metal/plastic
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Is as simple as this if the patella is lateral and dislocated, anteromedial TTO with a little distalization gets the patella safely inside the lateral convexity, raises the patella past the spur and unloads. Just rebuild the MPFC to further stabilize. Rarely need trochleoplasty
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If the patella is unstable and tracks laterally or with a J, move it to be stable. Leave the trochlear cartilage alone
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John Fulkerson retweeted
Breaking down tibial tuberosity to trochlear groove distance into two components to enable patient-specific treatment strategies. Learn more in this @JISAKOS original 👇 ow.ly/sPCH50Yp9pU
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The new era of tibial tubercle transfer. Custom 3-D printed AMTTO guides. Look for the Trivara guide
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First description of the MQTFL in world literature-2013. I am deeply indebted to Miho Tanaka for combining her anatomic dissections with mine subsequently in order to provide a more detailed description of the anatomy (JBJS, 2016) and then popularizing MQTFL reconstruction
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John Fulkerson retweeted
Just look at an AP view of a 3-D CT and you can see where the patella needs to go. Move the tibial tubercle to get I there, off of the flat or convex proximal trochlea. No need to excavate (deepening trochleoplasty) preserve the joint
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Just look at an AP view of a 3-D CT and you can see where the patella needs to go. Move the tibial tubercle to get I there, off of the flat or convex proximal trochlea. No need to excavate (deepening trochleoplasty) preserve the joint
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Flat proximal trochlea. 3D shows us the path. No excavation, just move the patella to where it needs to be for easy access to the trochlea- joint preservation
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John Fulkerson retweeted
Tibial tubercle transfer yields joint preservation in patella instability patients
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I’ve received images of seven failed trochleoplasties over the last few years, yet I haven’t seen an article on this topic. As I don’t do femoral trochleoplasties myself, other than proximal spur resections, I’d love to see images or comments on this topic. Attach in comments?
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Contrary to rumor, I am not retired, but doing less surgery- now focussed on 3D custom TTO guides at Yale Orthopedics.
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John Fulkerson retweeted
No guess work here. With 3D you see it all. Lateral entry to trochlea- just move the tibial tubercle to facilitate patella entry in a stable way. No need to alter the beautiful and congruous trochlea. Knee locked in extension- reliable TTTG, fixed proximal EPTP Easy with 3D plan
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