ArticleOrthopaedic journal of sports medicine2026
The Effects of Tibial Tuberosity-Trochlear Groove Distance on Lateral Translation of the Patella: A Cadaveric Biomechanical Study.
Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The tibial tuberosity-trochlear groove (TT-TG) distance is a key measurement in guiding surgical management of patellofemoral instability. A TT-TG of 20 mm is often used as the threshold for supplementing soft tissue procedures with tuberosity medialization, although this remains an active area of investigation. Purpose: To identify the relationship between TT-TG distance and the force required to cause lateral translation of the patella in a cadaveric model at 30º of flexion. Study Design: Descriptive laboratory study. Methods: Eight fresh-frozen human cadaveric knee specimens were acquired, and computed tomography scans were obtained to measure anatomic features of patellar instability. A flat tibial tuberosity osteotomy was performed. Specimens were mounted on an Instron ElectroPuls E10000 in 30° of flexion. The force (N) required to produce 10 mm of lateral patellar translation over a 1-second interval was measured under the following tibial tuberosity translation conditions: (1) native; (2) predetermined translation (+5, 10, and 15 mm from native); and (3) predetermined TT-TG values (10 to 25 mm by 5 mm increments). Results: For TT-TG values ≤20 mm, there was a significant negative linear relationship between the TT-TG distance and the force required for lateral patellar translation (-1.63 N/mm [95% CI, -1.637 to -1.629]; Conclusion: The force required to translate the patella laterally decreased linearly as the TT-TG distance increased up to 20 mm. However, for TT-TG distances >20 mm, our model showed variability in the relationship between force and TT-TG distance. Clinical Relevance: The linear relationship identified between translational force and anatomic alignment, with TT-TG distances <20 mm, suggests a predictable biomechanical response to tibial tuberosity translation. The disruption of this relationship >20 mm confirms a threshold at which patellofemoral biomechanics are altered.
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