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Tibial tubercle trochlear groove distance

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https://www.readbyqxmd.com/read/28666038/measuring-malalignment-on-imaging-in-the-treatment-of-patellofemoral-instability
#1
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
#2
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...
June 15, 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
#3
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...
June 13, 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
#4
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
#5
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...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28463535/risk-factors-and-time-to-recurrent-ipsilateral-and-contralateral-patellar-dislocations
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28032709/relationship-between-patellar-tracking-and-the-screw-home-mechanism-of-tibiofemoral-joint
#14
Li-Kang Zhang, Xiao-Meng Wang, Ying-Zhen Niu, Hui-Xin Liu, Fei Wang
OBJECTIVE: To demonstrate the effect of the screw-home motion on the stability of the patellofemoral joint, and investigate its mechanism of regulation of patellar tracking. METHODS: Twenty volunteers who met the criteria were examined. All subjects had axial computed tomography (CT) scanning performed on bilateral knees at 0° and 30° of flexion. Scanning began above the femorotibial articulation and femoral trochlear groove, and moved sequentially down to the level of the anterior tibial tubercle...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27941532/modification-of-the-alignment-between-the-tibial-tubercle-and-the-trochlear-groove-induced-by-temporary-hemiepiphysiodesis-for-lower-extremity-angular-deformities-a-trigonometric-analysis
#15
Dimitri Ceroni, Amira Dhouib, Laura Merlini, Georgios Kampouroglou
This study aimed to predict the modification of the alignment between the tibial tubercle (TT) and the trochlear groove (TG) that occurs during femoral or tibial hemiepiphysiodesis. MRI scans of 541 knees were retrospectively reviewed to determine the distances between the cranial insertion of the patellar tendon on the TT and the femoral physis (FP)/tibial physis (TP). Thereafter, we developed a trigonometric formula to calculate the predicted change of the TT-TG distance that occurs during hemiepiphysiodesis around the knee using both the planned angular correction as well as the length between the physis (both distal femoral and proximal tibial) and the insertion of the patellar tendon of the TT...
May 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27826597/are-the-current-classifications-and-radiographic-measurements-for-trochlear-dysplasia-appropriate-in-the-skeletally-immature-patient
#16
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
https://www.readbyqxmd.com/read/27613760/morphology-and-anatomic-patellar-instability-risk-factors-in-first-time-traumatic-lateral-patellar-dislocations-a-prospective-magnetic-resonance-imaging-study-in-skeletally-immature-children
#17
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...
January 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27574273/tibial-tubercle-to-trochlear-groove-distance-and-index-in-children-with-one-time-versus-recurrent-patellar-dislocation-a-magnetic-resonance-imaging-study
#18
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
https://www.readbyqxmd.com/read/27274449/patellofemoral-joint-reconstruction-for-patellar-instability-medial-patellofemoral-ligament-reconstruction-trochleoplasty-and-tibial-tubercle-osteotomy
#19
Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Tyler R Cram, Robert F LaPrade
Recurrent patellar instability can be very debilitating and may require surgical intervention. A thorough workup must be completed in this subset of patients. Risk factors for recurrent instability include patella alta, trochlear dysplasia, an increased tibial tubercle-trochlear groove distance, and insufficiencies in the medial retinacular structures. Necessary treatment of these risk factors, once identified, should be addressed surgically. Patellofemoral reconstruction must be individually tailored to each patient's anatomy and may necessitate medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, or trochleoplasty in any combination or as a standalone procedure...
February 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27184882/tt-tg-vs-modified-lateral-patellar-edge-for-determination-of-tibial-tubercle-transfer-distance-in-fulkerson-osteotomy-procedures
#20
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
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