Is tibial tuberosity-trochlear groove distance an appropriate measure for the identification of knees with patellar instability?

Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2377-81. doi: 10.1007/s00167-014-2954-0. Epub 2014 Mar 21.

Abstract

Purpose: Tibial tuberosity-trochlear groove distance (TT-TG) has been regarded as a useful tool for establishing therapeutic choices for patellar instability. Recently, it has been shown that TT-TG negatively correlated with the quadriceps angle, suggesting that if used individually, neither provide a valid measure of instability. This study aimed to compare TT-TG distance between both knees in patients with unilateral instability to assess whether this measurement is a decisive element in the management decisions for patellar instability.

Methods: Sixty-two patients (18 male and 44 female), reporting to a specialist patella clinic for recurrent unilateral patellar instability, were included in the study. Patients underwent bilateral long leg computed tomography scan to determine TT-TG distance in both knees. Tibial TT-TG in symptomatic and asymptomatic knees in the same individual was compared statistically.

Results: Mean TT-TG distance in the symptomatic knee was 16.9 (±4.9) mm, compared to 15.6 (±5.6) mm in the asymptomatic knee. Tibial TT-TG was not significantly different between stable and unstable knees (n.s.).

Conclusions: The lack of difference in TT-TG distance between stable and unstable knees suggests that TT-TG distance alone may not be a decisive element in establishing therapeutic choices for patellar instability. It should, therefore, be interpreted with caution during clinical evaluations.

Level of evidence: II.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Femur / diagnostic imaging
  • Humans
  • Joint Instability / diagnostic imaging*
  • Knee Joint / diagnostic imaging*
  • Male
  • Patella / diagnostic imaging
  • Quadriceps Muscle / diagnostic imaging
  • Retrospective Studies
  • Tibia / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Young Adult