My screws hurt when I kneel after a tibial tubercle osteotomy. Should they come out?

Why the screws can be felt

The tibial tubercle sits just under the skin with little padding, so screw heads in this area are often noticeable. Pressure from kneeling, floor sitting or sujood can make them ache, and some people feel them when crossing their legs or bumping the shin.

This is a common reason for a second, smaller operation, and it does not mean the osteotomy has failed.

When removal is considered

• The bone has fully healed on X-ray, which usually means waiting many months after the original surgery
• The discomfort clearly comes from the screw area rather than inside the knee
• Symptoms affect daily life, work or prayer positions
• You understand the small risks of a further procedure

Removing screws before solid healing risks the bone fragment shifting, so timing is decided with your surgeon.

What removal involves

It is usually done as a day case through the original scar. The screws are taken out and the wound closed. Most people walk the same day, with a short period of reduced kneeling and contact sport while the screw holes fill in. Your surgeon may combine it with an arthroscopy if there are symptoms inside the joint.

When pain is not from the screws

Pain inside or behind the kneecap, swelling, a feeling of instability or pain that worsens over time point to other causes, such as cartilage wear. These need assessment rather than screw removal alone. At Aman Hospital, Dr. Gelber examines the knee and reviews X-rays before advising on the next step.