ArticleJournal of ISAKOS : joint disorders & orthopaedic sports medicine2026
Breaking down tibial tuberosity to trochlear groove distance into two components to enable patient-specific treatment strategies.
Article in Journal of ISAKOS : joint disorders & orthopaedic sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07472088 (Assessing the Association Between WBCT PFJ Morphological Metrics and Knee Symptoms), which is not on this map. Cited by 3 papers.
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Assessing the Association Between WBCT PFJ Morphological Metrics and Knee Symptoms
Who cites it
3 citing papers in PubMed.
- Sagittal alignment and patellofemoral consequences of open wedge high tibial osteotomy: a comparative radiological and gait analysis of supratubercle and distal tibial tuberosity techniques.Journal of orthopaedic surgery and research · 2026Article
- Anterior Knee Pain and Excessive External Tibial Torsion in Female Patients: Rationale and Outcomes of Rotational Tibial Osteotomy.Journal of clinical medicine · 2026Review
- Knee rotation significantly increases measured tibial tubercle-trochlear groove distance in female patients with anterior knee pain: Findings after rotational measurement correction.Journal of experimental orthopaedics · 2026Article
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12 authors.
Funding
Abstract
objectiveTibial tuberosity to trochlear groove (TT-TG) distance serves as one of the main metrics for patellofemoral instability (PFI) surgical decision-making. The purpose of this study is to split TT-TG into translational (caused by bony morphology) and rotational (external tibiofemoral rotation) components, elucidate how those two components relate to each other, and determine how the components differ between recurrent PFI patients and controls.
methodsComputed tomography (CT) scans of PFI patients with at least two reported dislocation events, seen by our institution's orthopedic department, were retrospectively acquired. Control CT scans were acquired from the Multicenter Osteoarthritis Study (MOST). Three-dimensional (3D) landmarks were placed on the distal femora and the proximal tibias. TT-TG, its rotational and translational components, and tibiofemoral rotation were algorithmically calculated from these landmarks. The two cohorts' means were compared using Mann-Whitney U-tests. Pearson coefficients were used to evaluate the correlation between the TT-TG components. The reliability of the measurements was evaluated with intraclass correlation coefficients (ICCs). The minimal sample size for a power level of 0.80 was calculated with an a priori sample size calculation.
resultsA total of 26 PFI (sex parity; age: 24.6 ± 10.0 years) and 294 control knees (sex parity; age: 52.6 ± 7.0 years) were analyzed. Statistically significant differences for TT-TG (18.7 ± 4.8 vs. 12.0 ± 3.4 mm, p < 0.001), rotational (5.3 ± 2.5 vs. 1.0 ± 2.5 mm, p < 0.001) and translational (13.4 ± 3.7 vs. 11.0 ± 3.1 mm, p = 0.002) components of TT-TG, and tibiofemoral rotation (10.7 ± 4.7 vs. 1.9 ± 4.7°, p < 0.001) were found. No significant correlation between the components of TT-TG was found (p = 0.14, r
conclusionTT-TG can be split into (1) a translational component, primarily dependent on bony morphology, and (2) a rotational component, caused by external tibiofemoral rotation, both of which can lead to an elevated TT-TG measurement independently of each other. The rotational component is the primary factor for differences observed between PFI patients and controls but might vary between consequential patient scans. Our findings emphasize the importance of personalized treatment strategies tailored to individual patient profiles in treating patellar instability and will aid in more accurately targeted selection of surgical methods addressing either or both translational or rotational components of TT-TG. LEVEL OF EVIDENCE: III Case-Control study.
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