TTTT - Tibial Tuberosity Transposition Tool and Technique The present technique provides a method for proximal tibial tuberosity shifting after partial tibial crest osteotomy, without tuberosity pinning, distal cerclage wiring, or a system or method for holding the transposed proximal tibial tuberosity in position to verify patellar tracking and measuring before final bone fixation. A special tool was designed to achieve slow bone bending and proximal shifting of the tibial tuberosity. The tool allows the proximal part of the tibial tubercle to be moved medially or laterally, maintaining the shifted portion in position until patellar trochlear tracking is checked prior to final bone fixation. After transposition, the proximal part of the tibial tuberosity is fixed by inserting a pin between the tibial tubercle and the medial or lateral cortex of the osteotomised tibia. The pin is used as a spacer to prevent the tubercle from returning to its original position due to bone’s elastic memory until bony union develops.