Tibial tuberosity transfer is a surgical procedure performed for anterior knee pain or patellar instability to improve the patella orientation with respect to the knee joint or to offload the patellofemoral joint. This is performed as an open procedure following initial arthroscopic evaluation. In this procedure, a part of shin bone (tibial tuberosity) which is attached to patellar tendon is split, moved (either out or inferior) and re-fixed to shin bone (tibia) in a position to obtain a better patellar alignment. The re-fixation is performed using metal implants such as screw. It takes about two to three months for the bone to heal. You will be advised gradual physiotherapy protocol following the surgery.