Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
The contribution of the tibial tubercle to patellar instability: analysis of tibial tubercle-trochlear groove (TT-TG) and tibial tubercle-posterior cruciate ligament (TT-PCL) distances.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Tibial Tubercle-Trochlear Groove Distance Has Better Diagnostic Reliability Than Tubercle-Posterior Cruciate Ligament Distance For Predicting Patellar Instability: A Systematic Review.Orthopaedic surgery · 2023Pooled it
- Tibial tubercle to trochlear groove distance versus tibial tubercle to posterior cruciate ligament distance for predicting patellar instability: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Assessment of the reliability and validity of imaging measurements for patellofemoral instability: an updated systematic review.Skeletal radiology · 2022Pooled it
- Current evidence advocates use of a new pathologic tibial tubercle-posterior cruciate ligament distance threshold in patients with patellar instability.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Pooled it
- Assessing the correlation between vastus medialis obliquus cross-sectional area and patellofemoral instability: a comparative magnetic resonance imaging study.Archives of orthopaedic and trauma surgery · 2025Article
- A Magnetic Resonance Imaging-Based Clinical Prediction Model Accurately Identifies Patellar Instability Risk Using Common Patellofemoral Measurements.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Tibial tuberosity-trochlea groove distance is dependent on flexion angle and intra-articular version in different magnetic resonance imaging recording techniques.Journal of experimental orthopaedics · 2025Article
- Patellofemoral Instability in the Pediatric Population.Current reviews in musculoskeletal medicine · 2023Review
- Tibial Tubercle to Trochlear Groove Distance Measured by Posterior Condylar Reference Line on MRI Can Over-Evaluate Lateralization Deformity of Tibial Tubercle in Patients with Recurrent Patellar Dislocation.Journal of clinical medicine · 2022Article
- Assessment of Femoral Version Should be Assessed Independently of Conventional Measures in Patellofemoral Instability.The Iowa orthopaedic journal · 2021Article
- Radiologic Measurements in the Assessment of Patellar Instability: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2021Review
- Tibial Tubercle-Midepicondyle Distance Can Be a Better Index to Predict the Outcome of Medial Patellofemoral Ligament Reconstruction Than Tibial Tubercle-Trochlear Groove Distance.Arthroscopy, sports medicine, and rehabilitation · 2020Article
- Comparative study of the tibial tubercle-trochlear groove distance measured in two ways and tibial tubercle-posterior cruciate ligament distance in patients with patellofemoral instability.Journal of orthopaedic surgery and research · 2020Article
- Tibial Tubercle-Roman Arch Distance: A New Measurement of Patellar Dislocation and Indication of Tibial Tubercle Osteotomy.Orthopaedic journal of sports medicine · 2020Article
- Tibial tuberosity anteriomedialization vs. medial patellofemoral ligament reconstruction for treatment of patellar instability related to malalignment: Computational simulation.Clinical biomechanics (Bristol, Avon) · 2020Article
- Recurrent Patellofemoral Instability in the Pediatric Patient: Management and Pitfalls.Current reviews in musculoskeletal medicine · 2020Review
- Tibial Tubercle-Trochlear Groove Distance Is a Reliable and Accurate Indicator of Patellofemoral Instability.Clinical orthopaedics and related research · 2019Article
- A Knee Size-Independent Parameter for Malalignment of the Distal Patellofemoral Joint in Children.Advances in orthopedics · 2019Article
- Individualizing the tibial tubercle to trochlear groove distance to patient specific anatomy improves sensitivity for recurrent instability.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
- Early patellar dislocation can lead to tibial tubercle lateralization in rabbits.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study is to assess the reliability of measuring the tibial tubercle to posterior cruciate (TT-PCL) distance compared to the tibial tubercle to trochlear groove (TT-TG) distance on magnetic resonance imaging (MRI), establish baseline TT-PCL values in patellar instability patients, and determine the predictive value of an excessive TT-PCL distance (≥24 mm) for recurrent patellar instability compared to a TT-TG distance ≥20 mm.
methodsTT-TG and TT-PCL distances were calculated on MRI in a randomized and blinded fashion by two reviewers on 54 patients (59 knees) with patellar instability. Interobserver reliability was assessed using interclass correlation coefficients (ICC). TT-PCL distances were also assessed to establish mean values in patellar instability patients. The ability of excessive TT-PCL and TT-TG distances to predict recurrent instability was assessed by comparing odds ratios, sensitivities, and specificities.
resultsInterobserver reliability was excellent for both TT-TG (ICC = 0.978) and TT-PCL (ICC = 0.932). The mean TT-PCL in these 59 knees was 21.7 mm (standard deviation 4.1 mm). Twelve (20 %) of 59 knees had a single dislocation, and 47 (80 %) exhibited 2 or more dislocations. The odds ratios, sensitivities, and specificities of a TT-TG distance ≥20 mm for identifying patients with recurrent dislocation were 5.38, 0.213, and 1.0, respectively, while those of a TT-PCL distance ≥24 mm were 1.46, 0.298, and 0.583, respectively. Of the 10 knees with a TT-TG distance ≥20 mm, all 10 (100 %) had recurrent instability, while 14 (73.7 %) of the 19 knees with a TT-PCL ≥24 mm experienced multiple dislocations (n.s.).
conclusionBoth TT-PCL and TT-TG can be measured on MRI with excellent interobserver reliability. In this series, the mean TT-PCL value in patients with patellar instability was 21.8 mm, but the range was broad. A TT-PCL distance ≥24 mm was found to be less predictive of recurrent instability in this series. For patients experiencing multiple episodes of patellar instability in the setting of a normal TT-TG distance, obtaining the TT-PCL measurement may provide a more focused assessment of the tibial contribution to tubercle lateralization. LEVEL OF EVIDENCE: III.
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