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Tibial tubercle trochlear groove distance

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https://www.readbyqxmd.com/read/29102017/editorial-commentary-measuring-coronal-mal-alignment-for-patients-with-patellar-instability-tibial-tubercle-to-trochlear-groove-versus-tibial-tubercle-to-posterior-cruciate-ligament-distance
#1
EDITORIAL
Andrew J Cosgarea
Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29100777/anisometry-of-medial-patellofemoral-ligament-reconstruction-in-the-setting-of-increased-tibial-tubercle-trochlear-groove-distance-and-patella-alta
#2
Lauren H Redler, Kathleen N Meyers, Jacqueline M Brady, Elizabeth R Dennis, Joseph T Nguyen, Beth E Shubin Stein
PURPOSE: To assess the impact elevated tibial tubercle-trochlear groove (TT-TG) distance and patella height, as measured by the Caton-Deschamps Index (CDI), have on the isometry of a reconstructed medial patellofemoral ligament (MPFL). METHODS: Nine fresh-frozen cadaveric knees were placed on a custom testing fixture, with a fixed femur and a mobile tibia. A suture fixed to the MPFL origin on the patella and free to move at the Schöttle point on the femur represented a reconstructed MPFL...
October 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29094053/measurement-of-tibial-tuberosity-trochlear-groove-offset-distance-by-weightbearing-cone-beam-computed-tomography-scan
#3
John M Marzo, Melissa A Kluczynski, Anthony Notino, Leslie J Bisson
Background: Computed tomography (CT) scans are useful for objectively measuring bone alignment because they show bone detail particularly well, and these scans have been used extensively to assess patellar orientation. The tibial tubercle-trochlear groove (TT-TG) offset distance has been shown to be influenced by knee flexion and weightbearing, yet conventional CT scans are obtained with the subject relaxed, supine, and with the knee in full extension. A new cone-beam CT scanner has been designed to allow for weightbearing images, potentially providing a more physiologically relevant assessment of patellofemoral alignment...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29039139/individualizing-the-tibial-tubercle-to-trochlear-groove-distance-to-patient-specific-anatomy-improves-sensitivity-for-recurrent-instability
#4
Mark J Heidenreich, Thomas L Sanders, Mario Hevesi, Nicholas R Johnson, Isabella T Wu, Christopher L Camp, Diane L Dahm, Aaron J Krych
PURPOSE: An initial episode of patellar instability poses a treatment challenge given the absence of a valid, reproducible, and universally applicable predictor of recurrence. Recently, a series of patellar instability ratios (PIRs) were described. Each ratio consisted of the traditional tibial tubercle to trochlear groove (TT-TG) distance normalized to patient-specific measures. The purpose of this study was to investigate the reliability and validity of these novel measures. METHODS: Eighty-seven patients experiencing a first-time lateral patellar dislocation were identified in a retrospective manner...
October 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28942027/tibial-tubercle-torsion-a-new-factor-of-patellar-instability
#5
V Chassaing, J-M Zeitoun, M Camara, J-L Blin, S Marque, M-D Chancelier
INTRODUCTION: External torsion of the anterior tibial tubercle (TT), defined as external rotation around a craniocaudal axis with respect to the posterior femoral condylar plane, may induce patellar instability. To our knowledge no studies have focused on this parameter. The present study aimed to perform an MRI analysis of TT torsion. The study hypothesis was that TT torsion correlates with patellar instability and with 3 of its components: tibial tubercle-trochlear groove (TT-TG) distance, axial engagement index of the patella (AEI), and patellar tilt...
September 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28918500/current-evidence-advocates-use-of-a-new-pathologic-tibial-tubercle-posterior-cruciate-ligament-distance-threshold-in-patients-with-patellar-instability
#6
REVIEW
Nickolas Boutris, Domenica A Delgado, John S Labis, Patrick C McCulloch, David M Lintner, Joshua D Harris
PURPOSE: To determine (1) whether a correlation exists between tibial tubercle-posterior cruciate ligament (TT-PCL) and tibial tubercle-trochlear groove (TT-TG) distances in patellar instability patients; (2) reliability when measuring TT-PCL distance; (3) whether TT-PCL distances measured on MRI are equivalent to those on CT; and (4) whether a correlation exists between TT-PCL distance and number of instability events or recurrence of instability following stabilization surgery. METHODS: A systematic review was performed using PRISMA guidelines...
September 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#7
Lena Alm, Matthias Krause, Carolin Mull, Karl-Heinz Frosch, Ralph Akoto
BACKGROUND: Due to open femoral physis the therapy of patellar instability in skeletally immature patients is challenging. We developed a modified surgical technique of the 'Adductor-Sling-Approach' by Sillanpää. The purpose of this study was to evaluate the clinical outcome of the operative technique and to analyse the reasons for failure. METHODS: Thirty 'modified adductor sling' reconstructions in 28 patients were included in the study. From 2010 to 2016 modified adductor sling reconstruction was performed by looping the gracilis or semitendinosus tendon around the adductor magnus tendon and attaching it at the medial facet of the patella...
August 31, 2017: Knee
https://www.readbyqxmd.com/read/28666038/measuring-malalignment-on-imaging-in-the-treatment-of-patellofemoral-instability
#8
Miho J Tanaka, Andrew J Cosgarea
Assessment of malalignment is an important factor in determining surgical treatment options for patellar instability. Measurement of tibial tubercle-trochlear groove (TT-TG) distance is valuable in planning surgical treatment for patellar instability, because it quantifies a component of malalignment and aids in deciding whether to perform tibial tuberosity osteotomy. In this paper we review how TT-TG distance should be understood in the context of many measurement factors to allow for an individualized procedure that addresses the specific contributors to patellar instability in each patient...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28624557/arthroscopic-lateral-retinacular-release-medial-retinacular-plication-and-partial-medial-tibial-tubercle-transfer-for-recurrent-patellar-dislocation
#9
Song Chen, Yiqin Zhou, Qirong Qian, Yuli Wu, Peiliang Fu, Haishan Wu
OBJECTIVE: To assess the efficacy of a therapeutic protocol composed of arthroscopic lateral retinacular release, medial retinacular plication, and partial medial tibial tuberosity transfer for patients with recurrent patellar dislocation. METHOD: 71 patients, 11 males and 60 females and a total of 77 knees, with recurrent dislocation of the patella were enrolled between 1998 and 2012. The average age of the patients was 19.5 years and 67 of them had previous knee trauma history...
August 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28614288/evaluation-of-the-tibial-tubercle-to-posterior-cruciate-ligament-distance-in-a-pediatric-patient-population
#10
Blake Clifton, Dustin L Richter, Dan Tandberg, Matthew Ferguson, Gehron Treme
BACKGROUND: Evaluation of distal extensor mechanism alignment continues to evolve in children with patella instability. Prior studies support the use of the tibial tubercle to trochlear groove (TT-TG) distance but limitations exist for this measurement including: changes in the TT-TG distance with knee flexion, difficulty with finding the deepest part of a dysplastic trochlea, and limitations regarding identification of the site of the anatomic abnormality. The tibial tubercle-posterior cruciate ligament (TT-PCL) distance has been introduced as an alternative measure to address the shortcomings in the TT-TG distance by quantifying the position of the TT independent of the trochlea and with respect to the tibia only...
September 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#11
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#12
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28463535/risk-factors-and-time-to-recurrent-ipsilateral-and-contralateral-patellar-dislocations
#13
Tyson C Christensen, Diane L Dahm, Aaron J Krych, Rohith Mohan, Ayoosh Pareek, Thomas L Sanders
BACKGROUND: Previous studies have reported variable rates of recurrent lateral patellar instability mainly because of limited cohort sizes. In addition, there is currently a lack of information on contralateral patellar instability. PURPOSE: To evaluate the rate of recurrent ipsilateral patellar dislocations and contralateral patellar dislocations after a first-time lateral patellar dislocation. Additionally, risk factors associated with recurrent dislocations (ipsilateral or contralateral) and time to recurrence were investigated...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28451595/medial-patellofemoral-ligament-repair-versus-reconstruction-for-recurrent-patellar-instability-two-year-results-of-an-algorithm-based-approach
#14
Jason L Dragoo, Michael Nguyen, Corey T Gatewood, Jacob D Taunton, Simon Young
BACKGROUND: Patellar instability remains a challenging problem for both the patient and surgeon. Medial patellofemoral ligament (MPFL) repair has historically had poor results, and due to this, there is currently a trend toward reconstruction. PURPOSE/HYPOTHESIS: This study was undertaken to investigate experience with repair versus reconstruction of the MPFL using a multifactorial treatment algorithm approach. Our hypothesis was that there will be no significant difference in outcome scores between patients in the MPFL repair and reconstruction groups...
March 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28447139/early-patellar-dislocation-can-lead-to-tibial-tubercle-lateralization-in-rabbits
#15
Yingzhen Niu, Pengkai Cao, Chang Liu, Jinghui Niu, Xu Yang, Fei Wang
PURPOSE: To investigate the effects of early patellar dislocation on the tibial tubercle location. METHODS: Sixty knees from 30 healthy 1-month-old New Zealand white rabbits were randomly divided into two groups of 30 knees each. Group A (control group) comprised the left knees, which underwent no surgical procedures. Group B comprised the right knees, which underwent patellar dislocation surgery. Computed tomography (flexion 0°) was performed preoperatively and 6 months post-operatively...
April 26, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28419810/the-relationship-of-static-tibial-tubercle-trochlear-groove-measurement-and-dynamic-patellar-tracking
#16
Victor R Carlson, Frances T Sheehan, Aricia Shen, Lawrence Yao, Jennifer N Jackson, Barry P Boden
BACKGROUND: The tibial tubercle to trochlear groove (TT-TG) distance is used for screening patients with a variety of patellofemoral joint disorders to determine who may benefit from patellar medialization using a tibial tubercle osteotomy. Clinically, the TT-TG distance is predominately based on static imaging with the knee in full extension; however, the predictive ability of this measure for dynamic patellar tracking patterns is unknown. PURPOSE: To determine whether the static TT-TG distance can predict dynamic lateral displacement of the patella...
July 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28378138/q-vector-measurements-physical-examination-versus-magnetic-resonance-imaging-measurements-and-their-relationship-with-tibial-tubercle-trochlear-groove-distance
#17
Kristin H Graf, Marc A Tompkins, Julie Agel, Elizabeth A Arendt
PURPOSE: An increased lateral quadriceps vector has been associated with lateral patellar dislocation. Surgical correction of this increased vector through tibial tubercle medialization is often recommended when the quadriceps vector is "excessive". This can be evaluated by physical examination measurements of Q-angle and/or tubercle sulcus angle (TSA), as well as the magnetic resonance imaging (MRI) measurement of tibial tubercle-trochlear groove (TT-TG) distance. This study examined the relationship between three objective measurements of lateral quadriceps vector (TT-TG, Q-angle, TSA)...
April 4, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28267362/variability-in-patellofemoral-alignment-measurements-on-mri-influence-of-knee-position
#18
Alejandro Marquez-Lara, Jason Andersen, Leon Lenchik, Cristin M Ferguson, Pushpender Gupta
OBJECTIVE: The purpose of this study was to determine the variability of distances between four distinct anatomic landmarks used for the evaluation of patellofemoral alignment while implementing controlled changes in patient positioning during MRI. MATERIALS AND METHODS: Limited MRI was performed of 12 knees in healthy volunteers (10 men, two women; mean age, 28 years) with the knees in four different positions. The four landmarks used were TT (the most anterior point of the osseous tibial tubercle), TG (the nadir of the cartilaginous trochlear groove), PT (the center of the patellar tendon insertion on the tibia), and PCL (the medial border of the posterior cruciate ligament at its insertion along the posterior tibia)...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28178962/the-outcomes-of-the-modified-fulkerson-osteotomy-procedure-to-treat-habitual-patellar-dislocation-associated-with-high-grade-trochlear-dysplasia
#19
Hong Chen, Daohong Zhao, Jingming Xie, Qihui Duan, Jun Zhang, Zhidan Wu, Jia Jiang
BACKGROUND: Habitual patellar dislocation is not common in clinical practice, but it has a deep impact on the patient's lifestyle and movement. There has been no large case-control study on habitual patellar dislocation, and the management of it is still controversial. The aim of this study was to observe the efficacy of the modified Fulkerson procedure on patients with habitual patellar dislocation with high-grade trochlear dysplasia without trochleoplasty and to evaluate the results of this procedure...
February 8, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28056523/the-tibial-tubercle-trochlear-groove-distance-is-greater-in-patients-with-patellofemoral-pain-implications-for-the-origin-of-pain-and-clinical-interventions
#20
Victor R Carlson, Barry P Boden, Aricia Shen, Jennifer N Jackson, Lawrence Yao, Frances T Sheehan
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...
April 2017: American Journal of Sports Medicine
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