The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle–Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis

Tan, Si Heng Sharon; Lim, Beatrice Ying; Chng, Kiat Soon Jason; Doshi, Chintan; Wong, Keng Lin; Lim, Andrew Kean Seng; Hui, James

doi:10.1055/s-0039-1688563

Cited by 50 publications

(44 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Measurements made by CT and MRI have been investigated extensively in adults. 2,8,14,15,[19][20][21] Some researchers have investigated TT-TG measured on MRI in skeletally immature patients, who have high occurrence of PI. 4,6,10,17,25 However, no research has compared TT-TG distance measured between the 2 modalities in a pediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis of 5 studies, Tan et al 20 found an MD of 1.79 mm (95% CI, 0.91-2.68 mm) between CT and MRI for adults. The difference between the 2 modalities in children seems relatively greater than that in adults.…”

Section: Discussionmentioning

confidence: 99%

“…8,21,23,25 Studies in adults have found differences in TT-TG distances when measured by CT versus MRI, and whether measurements made by these 2 modalities are equivalent remains controversial. 2,8,14,15,[19][20][21] In pediatric populations with a high occurrence of PI, some researchers have investigated TT-TG measured on MRI and found that TT-TG may change with age or size of children. 4,6,10,17,25 Also, the relatively thick trochlear cartilage surface may obscure the anatomic landmarks of TT-TG.…”

mentioning

confidence: 99%

“…However, no research has compared TT-TG distance measured on MRI versus CT in these children. 2,8,14,15,[19][20][21] The aim of the current study was to investigate in skeletally immature patients (1) the effect of imaging modality (CT, MRI) and landmarks (cartilage, bone) on agreements of measurements of TT-TG, (2) differences in CT and MRI measurements of TT-TG, and (3) TT-TG distance in patients with and without PI.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

Dai

Lin

Zhang

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The tibial tubercle–trochlear groove (TT-TG) distance was originally described for computed tomography (CT), but it has been measured on magnetic resonance imaging (MRI) in patients with patellar instability (PI). Whether the TT-TG measured on CT versus MRI can be considered equivalent in skeletally immature children remains unclear. Purpose: To investigate in skeletally immature patients (1) the effects of CT versus MRI imaging modality and cartilage versus bony landmarks on consistency of TT-TG measurement, (2) the difference between CT and MRI measurements of the TT-TG, and (3) the difference in TT-TG between patients with and without PI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We retrospectively identified 24 skeletally immature patients with PI and 24 patients with other knee disorders or injury but without PI. The bony and cartilaginous TT-TG distances on CT and MRI were measured by 2 researchers, and related clinical data were collected. The interrater, interperiod (bony vs cartilaginous), and intermethod (CT vs MRI) reliabilities of TT-TG measurement were assessed with intraclass correlation coefficients. Results: The 48 study patients (19 boys, 29 girls) had a mean age of 11.3 years (range, 7-14 years). TT-TG measurements had excellent interrater reliability and good or excellent interperiod reliability but fair or poor intermethod reliability. TT-TG distance was greater on CT versus MRI (mean difference, 4.07 mm; 95% CI, 2.6-5.5 mm), and cartilaginous distance was greater than bony distance (mean difference, 2.3 mm; 95% CI, 0.79-3.8 mm). The TT-TG measured on CT was found to increase with the femoral width. Patients in the PI group had increased TT-TG distance compared with those in the control group, regardless of landmarks or modality used ( P > .05 for all). Conclusion: For skeletally immature patients, the TT-TG distance could be evaluated on MRI, regardless of whether cartilage or bony landmarks were used. Its value could not be interchanged with CT according to our results; however, further research on this topic is needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

Dai

Lin

Zhang

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…The odds of not being able to return to sports postoperatively as compared with preinjury was 2.78; however, this was not statistically significant, with the 95% CI being 0.53 to 14.68 (►Fig. 6). No publication bias was identified (p ¼ 0.385) (►Fig.…”

Section: Return To Sportsmentioning

confidence: 96%

The Outcomes of Isolated Lateral Release in Patellofemoral Instability: A Systematic Review and Meta-Analysis

et al. 2019

Self Cite

View full text Add to dashboard Cite

There have been conflicting reports regarding the outcomes of lateral release when used in the management of patellofemoral instability. This systematic review and meta-analysis therefore aims to evaluate the outcomes of isolated lateral release in the management of patellofemoral instability. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies that reported the outcomes of isolated lateral release for recurrent patellofemoral dislocations were included. A total of 10 publications were included, with 204 knees. All studies consistently reported a decrease in the rates of patellofemoral dislocation (odds ratio [OR] < 0.01; 95% confidence interval [CI]: <0.01–0.01) and an increase in the odds of having a good outcome (OR 0.01; 95% CI: <0.01–0.02) after lateral release. All studies also consistently reported a similar number of patients participating in sports postoperatively as compared with preinjury (OR 2.78; 95% CI: 0.53–14.68). A total of 28 (14.1%) out of 198 patients had postoperative dislocation. Of these patients, 15 required a secondary procedure for patellofemoral realignment; however, all patients who had their eventual outcomes reported still had a good outcome postoperatively. Isolated lateral release can lead to good short- to middle-term outcomes when used in the management of recurrent patellofemoral dislocations. The procedure can lead to a significantly decreased rate of recurrence of patellofemoral dislocations, a significantly increased rate of good outcomes, and a similar number of patients being able to participate in sports as compared with the number of patients participating in sports prior to having patellofemoral dislocations. An isolated lateral release could therefore potentially serve as a simple and relatively low-risk procedure that could be performed as a first-line surgical management in selected patients with patellofemoral instability, allowing them to possibly avoid a more complex and major operation. This is a Level IV study.

show abstract

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Chen,

Sha,

Zhang

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeNumerous methods have been proposed to characterise tubercle lateralisation. However, their normal values and related changes remain unclear. Accordingly, it was aimed to determine the potential sex and age effects and determined the optimal individualised method of diagnosing lateralisation of the tibial tubercle in patients with recurrent patellar dislocation (RPD).MethodsMeasurements included the tibial tubercle–trochlear groove (TT‐TG) distance, tibial tubercle‐posterior cruciate ligament (TT‐PCL) distance and tibial tubercle lateralisation (TTL); and the proximal tibial width (PTW), trochlear width (TW) and trochlear dysplasia index (TDI), for adjustment. A two‐way analysis of variance was used to determine the effect of age, sex and their interaction within the normal group. When the age effect was statistically significant, a nonlinear regression was created. Areas under the receiver‐operating characteristic curve (AUCs) were calculated to assess diagnostic accuracy.ResultsA total of 277 normal participants (mean [SD] age, 13.5 [2.6] years; 125 [45.1%] female) and 227 patients with RPD (mean [SD] age, 13.5 [2.6] years; 161 [58.1%] female) were analysed. It was found that in the normal group, in patients aged 7–10, TT‐PCL distance (p = 0.006), TTL (p = 0.007) and TT‐PCL/PTW (p < 0.001) were significantly larger in females than in males. A significant sex effect was also detected on TT‐TG/TW (p = 0.014). TT‐TG distance, TT‐PCL distance, TTL and TT‐PCL/PTW (in male patients) approached an established normal adult value of 12.3 mm, 20.9 mm, 0.64 and 0.28, respectively, with increasing age (p < 0.001). The AUC was greater for TT‐TG/TDI and TT‐TG/TW (p ≤ 0.01) and TT‐TG/TDI outperformed TT‐TG/TW in patients aged 15–18 (p = 0.004).ConclusionsTubercle lateralisation increased with age and was affected by sex, with the exception of TT‐TG distance and TT‐TG/TDI. TT‐TG/TDI is the optimal method of diagnosing a lateralized tibial tubercle in patients with RPD. These findings assist with the evaluation of tubercle lateralisation in that they provide a proper protocol for paediatric and adolescent populations with RPD; and thus, will help determine whether medial tubercle transfer should be included among the tailored surgical procedures considered for the treatment of patients with RPD.Level of EvidenceLevel III.

show abstract

The Difference between Computed Tomography and Magnetic Resonance Imaging Measurements of Tibial Tubercle–Trochlear Groove Distance for Patients with or without Patellofemoral Instability: A Systematic Review and Meta-analysis

Cited by 50 publications

References 34 publications

Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

The Outcomes of Isolated Lateral Release in Patellofemoral Instability: A Systematic Review and Meta-Analysis

Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations

Contact Info

Product

Resources

About