Tibial Tuberosity–Trochlear Groove Distance in Chinese Patients with or without Recurrent Patellar Dislocation

Tse, Michael Siu Hei; Lie, Chester Wai Hung; Pan, Nin Yuan; Chan, Chung-hong; Chow, Hung Lit; Chan, Wai Lam

doi:10.1177/230949901502300212

Cited by 9 publications

(15 citation statements)

References 5 publications

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“…[7][8][9][10]12,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] These included five publications that compared between TT-TG distances measured using CT and MRI, [7][8][9][10]12 and 21 publications that compared between TT-TG distances for patients with and without patellofemoral instability. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Collectively, these included a total of 3,040 patients. The details of the study design and patient population of all the studies are reported in ►Tables 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2019

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AbstractThe tibial tubercle–trochlear groove (TT–TG) distance was originally described for computed tomography (CT) but has recently been used on magnetic resonance imaging (MRI) without sufficient evidence demonstrating its validity on MRI. The current review aims to evaluate (1) whether there is a difference in the TT–TG distances measured using CT and MRI, (2) whether both the TT–TG distances measured using CT and MRI could be used to differentiate between patients with or without patellofemoral instability, and (3) whether the same threshold of 15 to 20 mm can be applied for both TT–TG distances measured using CT and MRI. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRSIMA) guidelines. All studies that compared TT–TG distances either (1) between CT and MRI or (2) between patients with and without patellofemoral instability were included. A total of 23 publications were included in the review. These included a total of 3,040 patients. All publications reported the TT–TG distance to be greater in patients with patellofemoral instability as compared to those without patellofemoral instability. This difference was noted for both TT–TG distances measured on CT and on MRI. All publications also reported the TT–TG distance measured on CT to be greater than that measured on MRI (mean difference [MD] = 1.79 mm; 95% confidence interval [CI]: 0.91–2.68). Pooling of the studies revealed that the mean TT–TG distance for the control group was 12.85 mm (95% CI: 11.71–14.01) while the mean TT–TG distance for patients with patellofemoral instability was 18.33 mm (95% CI: 17.04–19.62) when measured on CT. When measured on MRI, the mean TT–TG distance for the control group was 9.83 mm (95% CI: 9.11–10.54), while the mean TT–TG distance for patients with patellofemoral instability was 15.33 mm (95% CI: 14.24–16.42). Both the TTTG distances measured on CT and MRI could be used to differentiate between patients with and without patellofemoral instability. Patients with patellofemoral instability had significantly greater TT–TG distances than those without. However, the TT–TG distances measured on CT were significantly greater than that measured on MRI. Different cut-off values should, therefore, be used for TT–TG distances measured on CT and on MRI in the determination of normal versus abnormal values. Pooling of all the patients included in the review then suggest for 15.5 ± 1.5 mm to be used as the cut off for TT–TG distance measured on CT, and for 12.5 ± 2 mm to be used as the cut-off for TT–TG distance measured on MRI. The Level of evidence for this study is IV.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2019

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“…In the Chinese population, a smaller average measurement was found in asymptomatic individuals used as a control group, with mean of 10.1 mm in a sample size of 73 control knees. 17 The mean age in this cohort was 27 years (range 16-38 years). This age group is more appropriate for the concerned pathology which is usually present in adolescents and young adults.…”

Section: Discussionmentioning

confidence: 94%

“…Tse et al, for example, suggested that the threshold for tibial tuberosity transfer should be lower in Chinese patients due to these differences. 17 Some points for discussion may be raised regarding limitations to this study. Although the sample size for this study was relatively small (n=162 knees), it did exceed the required sample size of 68, with a chosen confidence level (CL) constant at 95%, an acceptable margin of error (MOE) of 10% and an SD of 0.5.…”

Section: Discussionmentioning

confidence: 96%

“…Previous international studies of this nature utilised comparable sample sizes of between 73 and 100. 10,[15][16][17] The consideration of inter-observer reliability with regard to performing the actual measurement should be taken into account when evaluating the strength of this study. [21][22][23] In this study only a single individual (a senior orthopaedic registrar) performed the measurements for data collection.…”

Section: Discussionmentioning

confidence: 99%

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Anthropometric differences in the tibial tuberosity to trochlear groove measurement in an African population

Rankin

Mohideen²

2019

SA orthop. j.

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Background: The tibial tuberosity to trochlear groove (TTTG) is a well-described radiographic measurement around the knee, which is of clinical significance in the assessment of patients with patellar instability. The TTTG is clinically relevant when considering the type of surgical procedures that may be required. The purpose of this retrospective observational study was to measure the TTTG measurement in the black African population and to compare it to the quoted norms in the literature. Methods: A random sample was obtained of 100 consecutive CT scans of lower limbs for vascular pathologies from black African patients. The TTTG was measured by a single observer on the Siemens ® syngo.plaza software. Results: CT scans of 162 knees from 88 patients met the inclusion criteria. The median age was 34 years (range 19-85 years; interquartile range [IQR] 24-50). The majority of cases were male (75%; n=121). The mean TTTG was 20.3 mm (standard deviation [SD] 16.1; range 1-29.2 mm). The mean TTTG in males was 20.7 mm (95% confidence interval [CI] 19.9-21.5 mm) and 19.1 mm (95% CI 17.6-20.5 mm) in females (p=0.06). There was no correlation found between age and TTTG (p=0.12). Conclusion: According to our study, barring some limitations, it appears that there may be a noteworthy difference in the TTTG measurement in the black African population. Larger comparative studies would be required to confirm these findings and to determine the clinical relevance.

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“…The TT-TG distances obtained on MR images have been found to be 3 to 4 mm less than those obtained on CT. 2, 20, 21 As a result, 15 and 20 mm have been proposed as thresholds for TT osteotomy using MRI and CT, respectively. 3, 12, 47 While many prior studies 13, 44, 48 have identified pathological TT-TG distances in patients with a history of patellar dislocations, the potential role and prevalence of this parameter in a large cohort with isolated PFP (ie, pain not secondary to patellar dislocations, osteoarthritis, or other knee trauma) are unclear. Yet, TT osteotomy has been performed in patients with isolated PFP without a clear understanding that the direction of pull on the patella from the patellar tendon is a likely contributing factor to PFP.…”

Section: Introductionmentioning

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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Tibial Tuberosity–Trochlear Groove Distance in Chinese Patients with or without Recurrent Patellar Dislocation

Cited by 9 publications

References 5 publications

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

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

Anthropometric differences in the tibial tuberosity to trochlear groove measurement in an African population

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

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