Clin Orthop Surg.  2018 Dec;10(4):420-426. 10.4055/cios.2018.10.4.420.

Factors Affecting Tibial Tuberosity-Trochlear Groove Distance in Recurrent Patellar Dislocation

• Prakash J
• Seon JK
• Ahn HW
• Cho KJ
• Im CJ
• Song EK

• KMID: 2426526
• DOI: http://doi.org/10.4055/cios.2018.10.4.420

Abstract

BACKGROUND
The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance.
METHODS
Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance.
RESULTS
We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, 7.9° vs. −0.81°).
CONCLUSIONS
Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.

Keyword

Patellar dislocation; Rotation; Tibia/diagnostic imaging

MeSH Terms

Femur
Humans
Knee
Osteotomy
Patella
Patellar Dislocation*
Retrospective Studies

Figure

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  Fig. 1 The tibial tuberosity trochlear groove distance was measured as the length between a line drawn from the deepest portion of the trochlear groove perpendicular to the posterior condylar line (A) and a line drawn parallel to this at the most prominent anterior portion of the tibial tuberosity (B).

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  Fig. 2 (A) Tibial tuberosity lateralization was presented as a percentage of the total tibial width. (B) The distance between the most prominent anterior portion of the tibial tuberosity and the medial perpendicular line showed the value of lateralization of tuberosity.

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  Fig. 3 Trochlear groove medialization was presented as a percentage of the total femoral width. The distance from the deepest portion of the groove to the medial perpendicular line showed the degree of medialization of the groove.

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  Fig. 4 The knee rotation angle was measured by a posterior condylar line of the femur (A) and a tibial posterior condylar line (B).

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