Evidence map›Paper›PMID 36877229›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023

Tibial tubercle to trochlear groove distance versus tibial tubercle to posterior cruciate ligament distance for predicting patellar instability: a systematic review.

Prushoth Vivekanantha, Harjind Kahlon, Ali Shahabinezhad, Dan Cohen, Kanto Nagai, Yuichi Hoshino, Darren de Sa

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Prushoth VivekananthaMichael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Harjind KahlonFaculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Ali ShahabinezhadUniversity Health Network, University of Toronto, Toronto, ON, Canada.
Dan CohenDivision of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main Street West, 4E14, Hamilton, ON, L8N 3Z5, Canada.
Kanto NagaiDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Yuichi HoshinoDepartment of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Darren de SaDivision of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main Street West, 4E14, Hamilton, ON, L8N 3Z5, Canada. darren.desa@medportal.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo determine the reliability and diagnostic accuracy of tibial tubercle-trochlear groove (TT-TG) distance versus tibial tubercle-posterior cruciate ligament (TT-PCL) distance, and to determine cutoff values of these measurements for pathological diagnosis in the context of patellar instability.

methodsThree databases MEDLINE, PubMed and EMBASE were searched from inception to October 5, 2022 for literature outlining comparisons between TT-TG and TT-PCL in patellar instability patients. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on inter-rater and intra-rater reliability, receiver-operating characteristic (ROC) curve parameters such as area under the curve (AUC), sensitivity and specificity, as well as odds ratios, cutoff values for pathological diagnosis and correlations between TT-TG and TT-PCL were recorded. The MINORS score was used for all studies in order to perform a quality assessment of included studies.

resultsA total of 23 studies comprising 2839 patients (2922 knees) were included in this review. Inter-rater reliability ranged from 0.71 to 0.98 and 0.55 to 0.99 for TT-TG and TT-PCL, respectively. Intra-rater reliability ranged from 0.74 to 0.99 and 0.88 to 0.98 for TT-TG and TT-PCL, respectively. AUC measuring diagnostic accuracy of patellar instability for TT-TG ranged from 0.80 to 0.84 and 0.58 to 0.76 for TT-PCL. Five studies found TT-TG to have more discriminatory power than TT-PCL at distinguishing patients with patellar instability from patients who do not. Sensitivity and specificity ranged from 21 to 85% and 62 to 100%, respectively, for TT-TG. Sensitivity and specificity ranged from 30 to 76% and 46 to 86%, respectively, for TT-PCL. Odds ratio values ranged from 1.06 to 14.02 for TT-TG and 0.98 to 6.47 for TT-PCL. Proposed cutoff TT-TG and TT-PCL values for predicting patellar instability ranged from 15.0 to 21.4 mm and 19.8 to 28.0 mm, respectively. Eight studies reported significant positive correlations between TT-TG and TT-PCL.

conclusionTT-TG resulted in overall similar reliability, sensitivity and specificity as TT-PCL; however, TT-TG has better diagnostic accuracy than TT-PCL in the context of patellar instability as per AUC and odds ratio values. LEVEL OF EVIDENCE: Level IV.

Indexed as

Joint InstabilityPatellar DislocationPatellofemoral JointPosterior Cruciate LigamentHumansMagnetic Resonance ImagingObserver VariationReproducibility of ResultsRetrospective StudiesTibiaDiagnostic accuracyPatellar dislocationReliabilityTT–PCLTT–TG

Identifiers

PMID36877229

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.