Computed Tomography-based Analysis of Tibial Tuberosity–Trochlear Groove Distance in Indian Population

Raja, Balgovind S.; Mohan, Hariharan; Jain, Akash; Balasubramanian, Sai Gautham

doi:10.7759/cureus.5277

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…Similar to our result, a CT‐based analysis of TT‐TG distance in the Indian population showed a mean TT‐TG distance with no significant differences between different sexes . 22 Thus, our findings provide new insights into TT‐TG measurements, which at any point under the femur pulley ditch can be used as a parameter to evaluate patellofemoral stability. A reference range for the TT‐TG distance of young and middle‐aged population was provided, and the TT‐TG threshold value should be reduced when assessing patellofemoral stability among the Chinese population.…”

Section: Discussionmentioning

confidence: 71%

Correlation Analysis between Tibial Tuberosity‐Trochlear Groove Distance and Other Patellar Stability Parameters in Young and Middle‐aged Populations

Yang

Liu

Sun

et al. 2022

Orthopaedic Surgery

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Objective The exact mechanism of patellofemoral instability has not been clearly clarified. The current study aims to explore the correlation between the tibial tuberosity‐trochlear groove (TT‐TG) distance and other patellar stability parameters. Methods A total of 60 individuals aged 18 to 40 years who underwent knee computed tomography (CT) examination between September 2014 and December 2017 were retrospectively recruited. Five reference sites were selected on the femoral trochlear articular surface in every CT image. The TT‐TG distance and the trochlear groove angles (TGA) at the five reference sites were measured. The patellar ligament length (PLL), patellar length (PL), medial patellar retinaculum length (MPRL) and lateral patellar retinaculum length (LPRL) were quantitatively analyzed. The TT‐TG distances on different knee sides or in different sexes were compared. The relationships between the TT‐TG distance and TGA, PLL/PL, MPRL, and LPRL were analyzed by Spearman's method. Comparison analysis among patellar stability parameters was analyzed using ANOVA or two‐tailed Student's t test. Results Variance analysis revealed no significant differences in the TT‐TG distances among the five positions of the femoral trochlea ( F = 0.67, P = 0.62) but significant differences among the five femoral TGAs at the five reference sites ( F = 380.37, P < 0.01). Notably, an increasing tendency of the TT‐TG distance was observed in the sexes (male, range 16.61–19.68 mm; female, range 14.37–17.38 mm) and knee sides (left knee, range 14.37–18.43 mm; right knee, range 15.80–19.68 mm). The TGA at site 1 of the femoral trochlear cartilage was the largest, with an angle of 151.97° ± 10.4°, and then gradually decreased to the smallest when the cartilage disappeared at site 5, with an angle of 92.05° ± 10.01°. Interestingly, there was a positive relationship between the TT‐TG distance at site 1 and TGA in the right knees of males ( r = 0.490, P = 0.033) as well as LPRL in the left knees of males ( r = −0.420; P = 0.046). There were no correlations between the TT‐TG distance and the other patellar stability parameters, including TGA, PLL/PL, MPRL, and LPRL. Conclusion Among young and middle‐aged populations, patella surgeries should be carefully determined based on the comprehensive consideration of these patellar stability parameters rather than the TT‐TG distance alone. Differences in sex and knee side should also be considered.

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Section: Discussionmentioning

confidence: 71%

Correlation Analysis between Tibial Tuberosity‐Trochlear Groove Distance and Other Patellar Stability Parameters in Young and Middle‐aged Populations

Yang

Liu

Sun

et al. 2022

Orthopaedic Surgery

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“…Various studies have evaluated the normal mean TT-TG distance in different ethnicities. 1,2,[5][6][7][8] However, there are limited studies in Southern Chinese population. It is crucial to determine the reference value for Southern Chinese population in order to apply TT-TG distance in clinical practice appropriately.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are many studies which had shown different reference values for different ethnicities. 1,2,[5][6][7][8] The first aim of this study is to determine the reference TT-TG distance on Magnetic Resonance Imaging (MRI) in Southern Chinese population. The second aim is to investigate the correlation between TT-TG distance and (i) age, (ii) sex, (iii) height, (iv) weight and (v) Body Mass Index (BMI) respectively.…”

Section: Introductionmentioning

confidence: 99%

Establishing the reference value for tibial tubercle-trochlear groove distance on MRI in Southern Chinese population and its correlation with age, sex, height, weight and size: A multi-centre study

Cho²,

Au³

et al. 2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Objective: The first objective of this study is to determine the reference Tibial Tubercle-Trochlear Groove (TT-TG) distance on MRI in Southern Chinese population. The second objective is to investigate the correlation between TT-TG distance and (i) age, (ii) sex, (iii) height, (iv) weight and (v) Body Mass Index (BMI) respectively. Method: Three hundred MRI knees performed in two different centres between August 2017 and October 2018 were included. All patients were prospectively recruited after MRI referral from Orthopaedics department. The TT-TG distances were measured by two radiologists independently. Measurement reliability was assessed using intraclass correlation coefficient (ICC). One sample t-test was used to compare the results between this study and other published studies. Spearman’s rank correlation coefficient was used to determine correlations between the TT-TG distance and age, sex, height, weight and BMI respectively. Result: There was no statistical significance between the mean of TT-TG distances from the two radiologists ( P-value = 0.32). The measurement reliability was excellent (ICC = 0.922 ± 0.02). The mean of averaged TT-TG distance was 8.32 ± 0.33 mm (range 2.01 to 17.48 mm). There were no statistical significant differences in means of TT-TG distance between laterality and gender. There were statistically significant correlations between (i) TT-TG distance and age ( p-value = 0.009), and (ii) TT-TG distance and height ( p-value = 0.014). Conclusion: The reference TT-TG distance on MRI in Southern Chinese population was 8.32 ± 0.33 mm. Statistically significant correlations were established between (i) TT-TG distance and age; and (ii) TT-TG distance and height.

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“…However, small sample sizes and diverse radiographic methods without standardization of patient positioning or the knee-flexion angle have precluded a consensus on the exact cutoff value 12,16 . Furthermore, insufficient data have been reported for the Chinese Han population, and variation between different populations has been detected and is not considered negligible [17][18][19] . The TT-TG distance is also affected by its components (i.e., tibial tubercle lateralization, trochlear groove medialization, and tibiofemoral rotation) 20 and femoral trochlear dysplasia 21,22 .…”

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confidence: 99%

Tibial Tuberosity-Trochlear Groove Distance and Its Components in Patients with and without Episodic Patellar Dislocation

Chen

et al. 2021

Journal of Bone and Joint Surgery

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Background:The purposes of the present study were (1) to measure the tibial tuberosity-trochlear groove distance and its components with the knee in extension, (2) to determine their diagnostic performance in distinguishing between patients with and without episodic patellar dislocation, and (3) to investigate the relationship of each component to the total tibial tuberosity-trochlear groove distance. Methods:We retrospectively reviewed computed tomography (CT) images of the knee joint in a group of patients with episodic patellar dislocation and a group of control subjects who were treated for another type of knee disorder in our institution between 2015 and 2021. Tibial tuberosity-trochlear groove distance, tibial tubercle lateralization, trochlear groove medialization, and knee rotation were measured on axial images. Partial correlation analysis of the measured parameters was performed after adjusting for remaining variables. Receiver operating characteristic (ROC) curves and the areas under the ROC curves (AUCs) were assessed to assess the diagnostic accuracy. A subgroup analysis based on femoral trochlear dysplasia classification was also performed.Results: After screening of 653 patients (947 knees) in our hospital's patient registry, a total of 521 patients (781 knees) were analyzed, including 541 knees (69.3%) with episodic patellar dislocation and 240 knees (30.7%) without episodic patellar dislocation (control group). The tibial tuberosity-trochlear groove distance demonstrated the best diagnostic performance, with the AUC being significantly better than that for other parameters (p < 0.001). The tibial tuberosity-trochlear groove distance was moderately to strongly correlated with knee rotation and trochlear groove medialization in the control and episodic patellar dislocation groups (p < 0.001). However, tibial tubercle lateralization showed a weak correlation with the tibial tuberosity-trochlear groove distance in the control group and moderate correlation in the episodic patellar dislocation group (p < 0.001). Knees with a type-D femoral trochlea had a significantly greater tibial tuberosity-trochlear groove distance than those with a type-A, B, or C femoral trochlea (p £ 0.011).Conclusions: Tibial tuberosity-trochlear groove distance, a reliable predictor of episodic patellar dislocation, was affected more by knee rotation and trochlear groove medialization and was less affected by tibial tubercle lateralization, and it increased with an increasing grade of femoral trochlear dysplasia. The correlation of the tibial tuberosity-trochlear groove distance and its components as noted in the current study will help to achieve a better understanding of the tibial tuberosity-trochlear groove distance.

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Computed Tomography-based Analysis of Tibial Tuberosity–Trochlear Groove Distance in Indian Population

Cited by 5 publications

References 18 publications

Correlation Analysis between Tibial Tuberosity‐Trochlear Groove Distance and Other Patellar Stability Parameters in Young and Middle‐aged Populations

Correlation Analysis between Tibial Tuberosity‐Trochlear Groove Distance and Other Patellar Stability Parameters in Young and Middle‐aged Populations

Establishing the reference value for tibial tubercle-trochlear groove distance on MRI in Southern Chinese population and its correlation with age, sex, height, weight and size: A multi-centre study

Tibial Tuberosity-Trochlear Groove Distance and Its Components in Patients with and without Episodic Patellar Dislocation

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