ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Increased external tibial torsion is an infratuberositary deformity and is not correlated with a lateralized position of the tibial tuberosity.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 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 and management of torsional malalignment in paediatric patients with patellofemoral joint instability.Journal of children's orthopaedics · 2026Article
- Idiopathic Adolescent Miserable Malalignment.Journal of the Pediatric Orthopaedic Society of North America · 2026Review
- In females with anterior knee pain, the infratuberositary contribution to external tibial torsion increases with torsion severity and does not correlate with tibial tubercle lateralisation.Journal of experimental orthopaedics · 2025Article
- Consistency of 3D reconstruction measurements of lower limb torsion at different segments with the CT gold standard.Scientific reports · 2025Article
- Derotational osteotomy is a relevant procedure in the management of lateral patellar dislocation: An expert survey of the International Patellofemoral Study Group.Journal of experimental orthopaedics · 2025Article
- Increased knee torsional misalignment associated with femoral torsion is related to non-contact anterior cruciate ligament injury: a case-control study.Journal of orthopaedic surgery and research · 2024Article
- Tibial Tuberosity Rotation in Patients With Patellar Instability Versus Age- and Sex-Matched Controls.Orthopaedic journal of sports medicine · 2023Article
- Correction of tibial tubercle trochlea groove distance is related to torsional correction in high tibial derotational osteotomy.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Correlation of Tibial Torsion With Lower Limb Alignment and Femoral Anteversion in Patients With Patellar Instability.Orthopaedic journal of sports medicine · 2022Article
- Torsional Abnormality: The Forgotten Issue in the Diagnosis and Treatment of the Anterior Knee Pain Patient.Journal of clinical medicine · 2022Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo perform a segmental analysis of tibial torsion in patients, with normal and increased external tibial torsion, suffering from chronic patellofemoral instability (PFI) and to investigate a possible correlation between tibial torsion and the position of the tibial tuberosity.
methodsPatients with chronic PFI who underwent torsional analysis of the lower limb using a standardized hip-knee-ankle MRI between 2016 and 2018 were included. For segmental analysis of tibial torsion, three axial levels were defined which divided the tibia into two segments: a distal, infratuberositary segment and a proximal, supratuberositary segment. Torsion was measured for the entire tibia (total tibial torsion, TTT), the proximal segment (proximal tibial torsion, PTT), and the distal segment (distal tibial torsion, DTT). Based on TTT, patients were assigned to one of two groups: Normal TTT (< 35°) or increased external TTT (> 35°). Position of the tibial tuberosity was assessed on conventional MRI scans by measuring the tibial tuberosity-trochlea groove (TT-TG) and the tibial tuberosity-posterior cruciate ligament (TT-PCL) distances.
resultsNinety-one patients (24 ± 6 years; 78% female) were included. Mean external TTT was 29.6° ± 9.1° and 24 patients (26%) had increased external TTT. Compared to patients with normal TTT, patients with increased external TTT demonstrated significantly higher values for DTT (38° ± 8° vs. 52° ± 9°; p < 0.001), whereas no difference was found for PTT ( - 13° ± 6° vs. - 12° ± 6°; n.s.). Furthermore, a significant correlation was found between TTT and DTT (p < 0.001), whereas no correlation was found between TTT and PTT (n.s). With regard to TT-TG and TT-PCL distances, no significant differences were observed between the two groups (TT-TG: 15 ± 6 vs. 14 ± 4 mm, n.s.; TT-PCL: 22 ± 4 vs. 21 ± 5 mm, n.s.) and no correlation was found with TTT, DTT, or PTT (n.s.).
conclusionIn patients with chronic PFI, increased external TTT of greater than 35° is an infratuberositary deformity and does not correlate with a lateralized position of the tibial tuberosity. LEVEL OF EVIDENCE: Level III.
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