Patellar instability: CT and MRI measurements and their correlation with internal derangement findings

Thakkar, Rashmi S.; Grande, Filippo Del; Wadhwa, Vibhor; Chalian, Majid; Andreisek, Gustav; Carrino, John A.; Eng, John; Chhabra, Avneesh

doi:10.1007/s00167-015-3614-8

Cited by 47 publications

(47 citation statements)

References 28 publications

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“…Three MR-based studies that used the same measurement technique described in the current study reported TT-TG distances of 14.6±4.6mm (n=109) 3 , 14.7±4.9mm (n=34) 8 , and 14.7±2.8mm (n=32). 46 In contrast, Dejour and Walch 13 studied subjects with a history of patellar dislocation using CT and and reported an average TT-TG distance of 20.0±1.6mm (n=110). 13 Based on these findings, TT-TG distances ≥15mm and ≥20mm have been proposed as the threshold for pathological categorization on MR and CT images, respectively, for patients with a history of patellar dislocation.…”

Section: Discussionmentioning

confidence: 99%

The Tibial Tubercle–Trochlear Groove Distance Is Greater in Patients With Patellofemoral Pain: Implications for the Origin of Pain and Clinical Interventions

et al. 2017

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Background The distance between the tibial tubercle (TT) and trochlear groove (TT-TG distance) is known to be greater in patients with patellar instability. However, the potential role and prevalence of pathological TT-TG distances in a large cohort of skeletally mature patients with isolated patellofemoral pain (PFP) are not clear. Purpose To determine if the mean TT-TG distance is greater in patients with PFP, who lack a history of patellar dislocations, knee trauma, or osteoarthritis, relative to healthy controls. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 50 knees (38 patients) with PFP and 60 knees (56 controls) without PFP formed the basis of this study. Magnetic resonance imaging was used to determine the TT-TG distance from 3-dimensional static scans. Results The cohort with PFP demonstrated a significantly greater mean TT-TG distance, relative to asymptomatic controls (13.0 vs 10.8 mm, respectively; P = 0.001). Among the cohort with PFP, 15 knees (30%) demonstrated TT-TG distances ≥15 mm, and 3 knees (6%) demonstrated TT-TG distances ≥ 20 mm. Conclusion Most adult patients with isolated PFP have elevated TT-TG distances compared with controls, which likely contributes to the force imbalance surrounding the knee..

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Section: Discussionmentioning

confidence: 99%

The Tibial Tubercle–Trochlear Groove Distance Is Greater in Patients With Patellofemoral Pain: Implications for the Origin of Pain and Clinical Interventions

et al. 2017

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“…In the literature, the inter-rater and intra-rater reliability of TT-TG measurement via MRI has been reported to be less than 10 percent. This study has shown that MRI is a reliable method for the evaluation of TT-TG [7,11,14,16].…”

Section: Discussionmentioning

confidence: 99%

“…It is also very difficult to determine the deepest point of the trochlear groove, and for this reason, significant measurement errors may occur [6]. MRI can evaluate soft tissue at a higher accuracy and does not involve radiation, and therefore its use is recommended for the pathologic diagnosis of patellofemoral ligaments [7]. In the present study, we evaluated the reliability of MRI in the measurement of the TT-TG distance and determined the normal values for this distance in males and females from different age groups based on knee examination and MRI findings.…”

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confidence: 99%

Evaluation of the normal tibial tubercle-trochlear groove distance with magnetic resonance imaging in a Turkish population

Kaplanoğlu¹

2019

Ann Clin Anal Med

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Aim: Patellar instability is a common multifactorial knee pathology with a high recurrence rate. In this condition, the symptoms often continue and result in the patient becoming susceptible to chondromalacia and osteoarthritis. Tibial tuberosity-trochlear groove distance (TT-TG) is very important in the evaluation of patellofemoral joint instability. In this study, we investigated the normal value of TT-TG distance in men and women of different age groups and evaluated the reliability of magnetic resonance imaging (MRI) in TT-TG distance measurement. Material and Method: The study was carried out between January 2017 and December 2017 on 99 patients over the age of 18, all reporting knee pain but presenting with normal knee examination and MRI findings. The patients with abnormal findings on knee MRI or physical examination were excluded from the study. Results: The mean age of the patients was 41.1 ± 11.0 years with a median of 40 (18-68) years. The mean TT-TG distance in the whole population was 9.3 ± 3.3 mm, with a mean value of 9.9 ± 3.6 mm in men and 8.8 ± 3.0 mm in women. Within the male and female patient groups, the TT-TG distance did not significantly differ by age (p = 0.646 and p = 0.570, respectively). Discussion:In the present study, no significant difference was identified in the TT-TG distance measurement between males and females in different age groups. From the results of this study, it can be concluded that MRI is a reliable method for the evaluation of TT-TG distance.

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“…These parameters provide us the severity of the deformity and it allows the surgeon to decide the best procedure [1] [4]. Dysplastic trochlea is shallow, flat or even convex.…”

Section: A Trochlear Dysplasiamentioning

confidence: 99%

“…There are some factors leading to patellar instability such as trochlear dysplasia, patellar tilt, patella alta and an excessive tibial tubercle-trochlear groove (TT-TG) distance [1][3] [4]. The MPFL rupture can be cited as a cause or a consequence, it depends if the dislocation occurs before or after the rupture.…”

Section: Introductionmentioning

confidence: 99%

Patellar instability: Traditional surgical interventions and a robotic approach

Serrador

Roberto

Santos

et al. 2017

2017 IEEE 5th Portuguese Meeting on Bioengineering (ENBENG)

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-Nowadays, knee complications are a common problem that can make it difficult for people to walk. One of these complications is patellar instability that can lead to recurrent patellar dislocations due to a morphological abnormality in patellofemoral joint. Due to all implications that this pathology may have for the affected person it is mandatory to treat it in order to improve the quality of life of these people. There are two principal surgeries that could be performed to treat patellar instability, depending on the severity and on the cause: trochleoplasty and tibial tubercle osteotomy. A description of the workflow of these surgeries will be presented, describing all steps and the instruments used. The main purpose of this article is to make a survey of the robotic systems that could be adapted to these interventions. This is a first approach to the application of robotic systems on these interventions. Research shows that this field of orthopedic surgery has a great potential to be improved using robotic systems. With a well-planned surgery and the development in the field of surgical robotics the duration of the surgery can be shorter as well as obtain a better result since there are precise instruments and procedures that could be adapted to perform these interventions.

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Patellar instability: CT and MRI measurements and their correlation with internal derangement findings

Abstract: IV.

Cited by 47 publications

References 28 publications

The Tibial Tubercle–Trochlear Groove Distance Is Greater in Patients With Patellofemoral Pain: Implications for the Origin of Pain and Clinical Interventions

The Tibial Tubercle–Trochlear Groove Distance Is Greater in Patients With Patellofemoral Pain: Implications for the Origin of Pain and Clinical Interventions

Evaluation of the normal tibial tubercle-trochlear groove distance with magnetic resonance imaging in a Turkish population

Patellar instability: Traditional surgical interventions and a robotic approach

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