Clin Orthop Surg.  2016 Mar;8(1):45-48. 10.4055/cios.2016.8.1.45.

Radiologic Measurement of Tibial Tuberosity-Trochlear Groove (TT-TG) Distance by Lower Extremity Rotational Profile Computed Tomography in Koreans

• Song EK
• Seon JK
• Kim MC
• Seol YJ
• Lee SH

• KMID: 2363944
• DOI: http://doi.org/10.4055/cios.2016.8.1.45

Abstract

BACKGROUND
Tibial tuberosity-trochlear groove (TT-TG) distance is important in the assessment and treatment of patellofemoral disorders. However, normal and pathological TT-TG values have not been established in Koreans. The purpose of this study was to evaluate the TT-TG distance in the Korean population using lower leg rotational profile computed tomography (CT) scans.
METHODS
One hundred rotational profile CT scans were retrospectively collected from patients without knee joint problems aged between 25 to 82 years. TT-TG distances were measured, and statistical analysis was performed. Each CT scan was measured twice in a blinded, randomized manner by three reviewers. Patients with pre-existing knee joint problems were excluded from the study; hence 15 of the 100 patients were excluded because of deformity or unreadable CT scans. Thus, 85 of the 100 patients were included in the study.
RESULTS
Interobserver and intraobserver reliability of TT-TG distance measurements was good. The median TT-TG distance for this Korean population was 11.24 mm (mean, 10.24 +/- 0.8 mm). TT-TG distance measured nearly 2 mm less on rotational profile CT scans.
CONCLUSIONS
Some of the TT-TG distances on rotational profile CT scans were significantly correlated, indicating that they could be accepted. Furthermore, the values on CT scans showed good reliability. In this study, the TT-TG distance in normal Korean people was approximately 10.24 mm without significant differences in TT-TG values between genders.

Keyword

Tibial tubercle-trochlear groove; Rotational profile computed tomography

MeSH Terms

Adult
Aged
Aged, 80 and over
Female
Femur/*anatomy & histology/*diagnostic imaging
Humans
Leg/anatomy & histology/diagnostic imaging
Male
Middle Aged
Reference Values
Republic of Korea
Tibia/*anatomy & histology/*diagnostic imaging
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A line tangent to the posterior epicondyle (a) and a perpendicular line through the deepest point of trochlea (b) are drawn. Another line parallel to the trochlea line through the most anterior portion of the tibial tuberosity (c) is drawn. Tibial tuberosity-trochlear groove distance (d) is measured between line (b) and (c).

Reference

1. Wilcox JJ, Snow BJ, Aoki SK, Hung M, Burks RT. Does landmark selection affect the reliability of tibial tubercletrochlear groove measurements using MRI? Clin Orthop Relat Res. 2012; 470(8):2253–2260.

2. Dejour H, Walch G, Nove-Josserand L, Guier C. Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc. 1994; 2(1):19–26.

3. Nagamine R, Miura H, Inoue Y, et al. Malposition of the tibial tubercle during flexion in knees with patellofemoral arthritis. Skeletal Radiol. 1997; 26(10):597–601.

4. Wittstein JR, Bartlett EC, Easterbrook J, Byrd JC. Magnetic resonance imaging evaluation of patellofemoral malalignment. Arthroscopy. 2006; 22(6):643–649.

5. Alemparte J, Ekdahl M, Burnier L, et al. Patellofemoral evaluation with radiographs and computed tomography scans in 60 knees of asymptomatic subjects. Arthroscopy. 2007; 23(2):170–177.

6. Lustig S, Servien E, Ait Si Selmi T, Neyret P. Factors affecting reliability of TT-TG measurements before and after medialization: a CT-scan study. Rev Chir Orthop Reparatrice Appar Mot. 2006; 92(5):429–436.

7. Saudan M, Fritschy D. AT-TG (anterior tuberosity-trochlear groove): interobserver variability in CT measurements in subjects with patellar instability. Rev Chir Orthop Reparatrice Appar Mot. 2000; 86(3):250–255.

8. Fulkerson JP. Patellofemoral pain disorders: evaluation and management. J Am Acad Orthop Surg. 1994; 2(2):124–132.

9. Schoettle PB, Zanetti M, Seifert B, Pfirrmann CW, Fucentese SF, Romero J. The tibial tuberosity-trochlear groove distance; a comparative study between CT and MRI scanning. Knee. 2006; 13(1):26–31.

10. Balcarek P, Walde TA, Frosch S, et al. Patellar dislocations in children, adolescents and adults: a comparative MRI study of medial patellofemoral ligament injury patterns and trochlear groove anatomy. Eur J Radiol. 2011; 79(3):415–420.

11. Grelsamer RP. Patellar malalignment. J Bone Joint Surg Am. 2000; 82(11):1639–1650.

12. Biedert RM, Warnke K. Correlation between the Q angle and the patella position: a clinical and axial computed tomography evaluation. Arch Orthop Trauma Surg. 2001; 121(6):346–349.

13. Wright JG, Feinstein AR. Improving the reliability of orthopaedic measurements. J Bone Joint Surg Br. 1992; 74(2):287–291.