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Introduction
In the Lyon school after the “6
e
Journées
Lyonnaises de Chirurgie du Genou” entitled
“Pathologie Fémoro-Patellaire”, hold in Lyon
under the direction of H. Dejour and G. Walch,
we considered two periods.
Before 1987
In the past, many surgical techniques were
proposed to manage patellofemoral disorders
as patellectomy, Maquet, patellectomie+
Maquet, Hauser, Goldwaith. At this time,
simple biomechanical theory including the
force Fq was used to understand patellar
dislocation and clinical evaluation of the lateral
implantation of the ATT was very limited (Q
angle, baïonnette sign).
The Roux Elmslie Trillat period
In order to correct the lateral implantation of
the ATT, a medialisation of the ATT was
proposed. In 1959, the first results of the
medialisation of the ATT were reported in the
Jaqueline Ledeuil thesis (A. Trillat department).
The history of the publications of the Elmslie
technique is really special. According to an
original letter written by A. Trillat himself and
given by G Gacon. So “quae sunt Caesaris,
Caesari”!
A. Trillat wrote :
“Dear Friend,
Cesar Roux has published in 1888 in the
“Revue de chirurgie” the original technique
that did not change a lot. It’s a part of the
tendon, keeping the insertion of the patellar
tendon on the tibial tuberosity and then transfer
medially. Very different from the Hauser’s
technique.
On 1944 visiting London I met Jim Seddon, a
pupil of Elmslie, who explained me what
Elmslie was doing in order to realign the
extensor mechanism. This author had never
published anything about it. At this time, I was
not aware Roux’s publication and when I came
back to France, I named this technique the
“Elmslie’s technique” and this terminology
was spread out very quickly.
Fifteen years later, I finally discovered the
Roux’s publication (100% identical to the
Elmslie technique). I imagine that Elmslie also
found this publication. He had never referred
to him due to the fact, I suspect, that Elmslie
Medial Transfer of the
Anterior Tibial Tuberosity
Historical considerations
P. Neyret, R.A. Magnussen, E. Servien,
S. Lustig, G. Demey, V.B. Duthon