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TT-TG distance

Jatin Prakash, Jong-Keun Seon, Seong-Hwan Woo, Cheng Jin, Eun-Kyoo Song
Purpose: Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis. Materials and Methods: We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups...
December 1, 2016: Knee Surgery & related Research
Matthew Stepanovich, James D Bomar, Andrew T Pennock
BACKGROUND: The assessment and classification of trochlear dysplasia in pediatric patients has yet to be well documented or validated. PURPOSE: To examine several different measurements/classifications of trochlear dysplasia in skeletally immature patients to assess inter- and intraobserver reliability and to determine which best correlates with patellar instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Radiographs and magnetic resonance imaging (MRI) scans of 36 skeletally immature patients undergoing surgery for patellar instability were compared with 27 age-matched cohort patients who had similar imaging for an acute knee injury but no clinical evidence of patellar instability...
October 2016: Orthopaedic Journal of Sports Medicine
Laurie Anne Hiemstra, Sarah Kerslake, Mark Lafave
PURPOSE: The WARPS/STAID classification employs clinical assessment of presenting features and anatomic characteristics to identify two distinct subsets of patients within the patellofemoral instability population. The purpose of this study was to further define the specific demographics and the prevalence of risky pathoanatomies in patients classified as either WARPS or STAID presenting with recurrent patellofemoral instability. A secondary purpose was to further validate the WARPS/STAID classification with the Banff Patella Instability Instrument (BPII), the Marx activity scale and the Patellar Instability Severity Score (ISS)...
October 7, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
G Pemmaraju, J Bassett, R Abbas, G Nagra, S Chugh, E Mughal
Patellofemoral instability is multifactorial and is associated with pathomechanics secondary to anatomical variance. Surgical management of this problem must be tailored to each patient and a thorough clinical and radiological assessment of the anatomical alignment should be carried out pre-operatively. The aim of this study is to assess the role of medial patellofemoral ligament reconstruction combined with tibial tuberosity transfer in patients with increased tibial tuberosity to trochlear groove (TT-TG) distance...
August 2016: Acta Orthopaedica Belgica
Marie Askenberger, Per-Mats Janarv, Throstur Finnbogason, Elizabeth A Arendt
BACKGROUND: The incidence of primary lateral patellar dislocation (LPD) in children aged 9 to 14 years is 0.6 to 1.2 per 1000. Causation is assumed to be multifactorial, including anatomic variants of the patellofemoral (PF) joint that result in a higher risk of LPD. No publication has compared the morphology of the PF joint and anatomic patellar instability risk factors (APIFs) in a primary LPD population versus controls, defining children by skeletal maturity. PURPOSE: To characterize the PF morphology and APIFs (trochlear dysplasia, abnormal lateral patellar tilt, elevated tibial tubercle-trochlear groove [TT-TG] distance, patella alta) through magnetic resonance imaging (MRI) measurements in skeletally immature children with and without a primary LPD and to identify (potential) distinctive differences between these 2 groups...
September 9, 2016: American Journal of Sports Medicine
C S N Yeoh, K Y Lam
PURPOSE: To compare the tibial tubercle to trochlear groove (TT-TG) distance and index using magnetic resonance imaging (MRI) between children with onetime and recurrent patellar dislocation. METHODS: Records of first-time acute patellar dislocations from 2007 to 2012 were reviewed. 20 males and 23 females aged 10 to 17 years at presentation were included for measurements of the bony and cartilaginous-tendon TT-TG distance and index. Recurrent patellar dislocation was defined as having more than one episode of dislocation within 2 years of the index injury...
August 2016: Journal of Orthopaedic Surgery
Kars P Valkering, Aysha Rajeev, Nick Caplan, Wim E Tuinebreijer, Deiary F Kader
PURPOSE: Medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability has gained popularity, and anatomical and biomechanical studies have recently altered our operative techniques. The aim of this study was to report the clinical outcome of this new anatomical MPFL reconstructive technique and investigate whether correlating factors could be identified. METHODS: Between 2009 and 2012, a total of 31 consecutive patients underwent MPFL reconstruction using an autologous gracilis graft and anatomical tunnel placement...
August 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alan Edwards, Evan Larson, Mitchell Beckert, Nikhil Sahai, John P Albright
BACKGROUND: Tibial tubercle-trochlear groove (TT-TG) distance is currently used at our institution to determine tibial tubercle medialization required in Fulkerson osteotomies. If the correlation between a modified lateral patellar edge (LPE) and the transfer distance was found to be stronger than its correlation with TT-TG, it would suggest that the best measurement to use is actually modified LPE. METHODS: The electronic medical records of 32 patients who underwent Fulkerson osteotomy procedures with femoral nerve stimulation were reviewed and measured...
August 2016: Knee
Zhu Dai, Di You, Ying Liao, Zhiwei Chen, Jiabin Peng
OBJECTIVE: To explore the treatment methed of recurrent patellar dislocation associated with old osteochondral fracture and to evaluate its effectiveness. METHODS: Between August 2010 and August 2014, 12 cases of recurrent patellar dislocation with old osteochondral fracture were treated. There were 4 males and 8 females with an average age of 18.3 years (range, 15-24 years). The left knee was involved in 7 cases and the right knee in 5 cases. All the patients had a history of patellar dislocation, the average interval from injury to first hospitalization was 7...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Betina B Hinckel, Riccardo G Gobbi, Eduardo N Kihara Filho, Marco K Demange, José Ricardo Pécora, Marcelo B Rodrigues, Gilberto Luis Camanho
PURPOSE: To determine whether the tibial tuberosity-to-trochlear groove distance (TT-TG) and patellar tendon-to-trochlear groove distance (PT-TG) are equal, whether the bony and cartilaginous points coincide in the trochlea, and whether the insertion of the PT coincides with the most anterior point of the TT in patients with patellar instability. METHODS: Fifty-three MRI scans of patients with patellar instability were examined. TT-TG and PT-TG were measured by three examiners in 31 knees...
March 31, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Eun Kyoo Song, Jong Keun Seon, Min Cheol Kim, Young-Jun Seol, Seung Hun Lee
BACKGROUND: Tibial tuberosity-trochlear groove (TT-TG) distance is important in the assessment and treatment of patellofemoral disorders. However, normal and pathological TT-TG values have not been established in Koreans. The purpose of this study was to evaluate the TT-TG distance in the Korean population using lower leg rotational profile computed tomography (CT) scans. METHODS: One hundred rotational profile CT scans were retrospectively collected from patients without knee joint problems aged between 25 to 82 years...
March 2016: Clinics in Orthopedic Surgery
Shuhei Otsuki, Mikio Nakajima, Kenta Fujiwara, Yoshinori Okamoto, Go Iida, Tomohiko Murakami, Masashi Neo
PURPOSE: To evaluate the clinical outcomes of three-dimensional (3D) transfer of the tibial tuberosity for patellar instability with patella alta, with a focus on the influence of age at initial surgery. METHODS: Three-dimensional surgery was performed on 28 knees with a mean follow-up of 46 months. Patients were separated into three groups based on the age at initial surgery: group A, 10 knees and an average age of 16.3 ± 1.8 (14-19) years; group B, 10 knees and an average age of 22...
February 2, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
David Y Ding, Raymond Kanevsky, Eric J Strauss, Laith M Jazrawi
INTRODUCTION: Recurrent patellar instability can be a source of continued pain and functional limitation in the young, active patient population. Instability in the setting of an elevated tibial tubercle-trochlear groove (TT-TG) distance can be effectively managed with a tibial tubercle osteotomy. At the present time, clinical outcome data are limited with respect to this surgical approach to patellar instability. METHODS: A retrospective chart review was performed to identify all cases of tibial tubercle osteotomy for the management of patellar instability performed at our institution with at least 1 year of post-operative follow-up...
March 2016: Injury
Alicia Worden, Scott Kaar, Joshua Owen, Adnan Cutuk
Background A lateralized tibial tubercle is an important anatomic predictor of patellar instability and can be used as an indication for a distal realignment procedure. Currently, tibial tubercle to trochlear groove (TT-TG) distance is measured on computed tomography (CT); however, radiographs could be a safer and more efficient modality. The aim of this study is to evaluate and compare TT-TG measurements obtained using CT, anatomical dissections, and a novel radiographic technique. Furthermore, we evaluated the effects of knee flexion and tibial rotation on these measurements...
December 30, 2015: Journal of Knee Surgery
Li Yin, Cheng Chen, Xiaojun Duan, Bing Deng, Ran Xiong, Fuyou Wang, Liu Yang
BACKGROUND: The purpose of the present study was to determine whether the image levels of the distal femur affected the measurement of the tibial tubercle-trochlear groove (TT-TG) distance. METHODS: Thirty sets of computer tomography (CT) images and 30 sets of MR images of the knee were evaluated. The TT-TG distance was quantified at multiple image levels in 1.5-mm increments, covering the proximodistal range of the trochlear groove. The CT measurement was based on osseous landmarks; the magnetic resonance imaging (MRI) measurement was based on cartilaginous and osseous landmarks...
November 16, 2015: Journal of Orthopaedic Surgery and Research
Betina B Hinckel, Riccardo G Gobbi, Eduardo N Kihara Filho, Marco K Demange, José Ricardo Pécora, Gilberto Luis Camanho
BACKGROUND: The tibial tubercle-trochlear groove (TT-TG) is used as the gold standard for patellofemoral malalignment. PURPOSE: To assess 3 patellar tendon-trochlear groove (PT-TG) angle measurement techniques and the PT-TG distance measurement (tendinous cartilaginous TT-TG) as predictors of patellar instability. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3. METHODS: Three PT-TG angle measurements and the PT-TG distance were measured in 82 participants with patellar instability and 100 controls using magnetic resonance imaging (MRI)...
September 2015: Orthopaedic Journal of Sports Medicine
Jake Daynes, Betina Bremer Hinckel, Jack Farr
When trochlear dysplasia is present, it is difficult to measure the tibial tuberosity to trochlear groove (TT-TG) distance. A new measurement to assess tuberosity position was recently described by Seitlinger et al, which avoids the difficulty of identifying the TG as it references the posterior cruciate ligament (PCL). To evaluate the reproducibility of the Seitlinger et al findings, 42 knees in 41 patients with a documented history of recurrent patellar instability and 84 knees in patients with no history of patellar instability or patellofemoral symptoms were evaluated with magnetic resonance imaging...
August 2016: Journal of Knee Surgery
Hong Chen, Daohong Zhao, Jun Zhang, Zhengdong Yang, Zhidan Wu, Jingming Xie
OBJECTIVE: To introduce and analyze the role of tibial tubercle internal rotation to treat recurrent patellar dislocation associated with trochlear dysplasia. METHODS: Between February 2007 and April 2011, 28 patients with recurrent patellar dislocation underwent tibial tubercle translocation through medial transfer, rotation and elevation of the tibial tuberosity and the medial patellofemoral ligament (MPFL) reconstruction. There were 4 males and 24 females with an average age of 21...
January 2015: Chinese Journal of Reparative and Reconstructive Surgery
Ariel A Williams, John J Elias, Miho J Tanaka, Gaurav K Thawait, Shadpour Demehri, John A Carrino, Andrew J Cosgarea
PURPOSE: To evaluate the role of tibial tuberosity-trochlear groove (TT-TG) distance in patellofemoral kinematics by retrospectively reviewing the dynamic computed tomography scans of patients with unilateral patellofemoral instability and comparing unstable and contralateral asymptomatic knees. METHODS: We reviewed all dynamic computed tomography scans obtained at one tertiary care hospital from 2008 through 2013 and identified 25 patients with a history of recurrent unilateral patellofemoral instability...
January 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Keisuke Kita, Yoshinari Tanaka, Yukiyoshi Toritsuka, Hiroshi Amano, Ryohei Uchida, Rikio Takao, Shuji Horibe
BACKGROUND: Many factors are involved in causing patellar instability or recurrent patellar dislocations. However, factors affecting the outcomes of anatomic medial patellofemoral ligament (MPFL) reconstruction have not been fully documented. PURPOSE: To evaluate the rate of recurrent patellar instability after isolated MPFL reconstruction and to elucidate factors affecting the outcomes of isolated MPFL reconstruction using multivariable statistics. STUDY DESIGN: Case-control study; Level of evidence, 3...
December 2015: American Journal of Sports Medicine
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