As a method to address patellofemoral pain, chondrosis, and malalignment, Fulkerson introduced anteromedialization of the tibial tuberosity. Short- and intermediate-term follow-up demonstrate efficacy. Patellofemoral cartilage lesion extent and region analysis allows for refined indications to optimize results. This article reviews the historical background, technique, results, and biomechanical rationale. The overview will assist in optimally integrating the procedure in the treatment armamentarium for patellofemoral disease.