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. 2022 Mar;3(3):268-274.
doi: 10.1302/2633-1462.33.BJO-2021-0107.

Tibial tuberosity-trochlear groove distance: does it measure up?

Harry Krishnan  1 , Jonathan D Eldridge  2 , Damian Clark  2 , Andrew J Metcalfe  3 , Jarrad M Stevens  4 , Vipul Mandalia  5
Affiliations

Tibial tuberosity-trochlear groove distance: does it measure up?

Harry Krishnan et al. Bone Jt Open. 2022 Mar.

Abstract

Recognized anatomic variations that lead to patella instability include patella alta and trochlea dysplasia. Lateralization of the extensor mechanism relative to the trochlea is often considered to be a contributing factor; however, controversy remains as to the degree this contributes to instability and how this should be measured. As the tibial tuberosity-trochlear groove (TT-TG) is one of most common imaging measurements to assess lateralization of the extensor mechanism, it is important to understand its strengths and weaknesses. Care needs to be taken while interpreting the TT-TG value as it is affected by many factors. Medializing tibial tubercle osteotomy is sometimes used to correct the TT-TG, but may not truly address the underlying anatomical problem. This review set out to determine whether the TT-TG distance sufficiently summarizes the pathoanatomy, and if this assists with planning of surgery in patellar instability. Cite this article: Bone Jt Open 2022;3(3):268-274.

Keywords: Patellar instability; TT-TG; Tibial tuberosity; dysplastic trochlear; knee; osteotomy; patella; patella alta; pathoanatomy; stability; strengths; tibial tubercle osteotomy; tibial tuberosity-trochlear groove (TT-TG) distances; trochlea; trochlear groove.

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Conflict of interest statement

ICMJE COI statement: D. Clark reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Stryker; and a leadership or fiduciary role in a board, society, committee or advocacy group for Stadium Clinic, OSC, Rebus Medicolegal, and the British Patellofemoral Society, all of which are unrelated to this article. A. J. Metcalfe declares being the chief investigator for multiple NIHR funded studies and co-investigator for others. For three of these (START:REACTS, RACER-Knee, and RACER-Hip), Stryker pay for some of the treatment costs for people who participate. A. J. Metcalfe also reports being a member of a trial steering committee for three publicly-funded studies, and research lead for the British Association for Surgery of the Knee and the British Patellofemoral Society, all of which is also unrleated to this work.

Figures

Fig. 1
Fig. 1
Illustration of tibial tuberosity-trochlear groove measurement.
Fig. 2
Fig. 2
Tibial tubercle-trochlear groove percentile growth chart.
Fig. 3
Fig. 3
Illustration of tibial tubercle-posterior cruciate ligament measurement.
See this image and copyright information in PMC

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