The Tibial Tubercle Trochlear Groove (TT-TG) distance is one of the most commonly used measurement methods to quantify the lateralized patellar tendon insertion. However, this measurement is based on an absolute value that does not consider the patient's size and could over or underestimate the need for a medialization of the tibial tubercle. The aim of this study is to propose a ratio combining the TT-TG distance and the posterior bicondylar width (PBCW) to more precisely differentiate which patients have an altered TT-TG.

Methods

A retrospective cohort of objective patellofemoral instability (OPI) patients was compared to a control cohort. TT-TG distance and PBCW were measured on MRI, and a TT-TG ratio was defined using both measurements. Receiver operating characteristic (ROC) curves and the area under the ROC curve were used to assess diagnostic accuracy. Pearson’s correlation analysis was performed to examine the relationship between TT-TG and continuous variables. Reliability was tested using the intraclass correlation coefficient (ICC).

Results

A total of 138 knees were included in the OPI group and 107 knees in the control group. A significant difference in TT-TG distance was found between the OPI group (mean 15mm ± 5.2) and the control group (mean 8.6mm ± 3.6) (p < .001). A significant difference in TT-TG ratio was found between the study group (22.3% ± 3) and the control group (11.7% ± 4.6) (p < .001). The TT-TG distance had an AUC of 0.848, and the TT-TG ratio had an AUC of 0.892. TT-TG distance (p = 0.02) and PBCW (p < .001) were significantly different according to gender within the OPI cohort, while the TT-TG ratio did not show significant differences (p = 0.84). The ICCs for intra and inter-rater reliability were excellent for both TT-TG absolute and TT-TG ratio.

Conclusion

The TT-TG ratio demonstrated enhanced diagnostic accuracy compared to TT-TG distance without presenting differences in terms of sex or patient size. This personalized approach allows a more precise evaluation of the necessity for tibial tubercle transfer osteotomy, mitigating the risk of either overestimating or underestimating the indication for this procedure.

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Initial Results from the Creation of a Normative Database for the Banff Patellar Instability Instrument ePoster Presentation Mark Lafave, PhD, CAT(C), CANADA Laurie A. Hiemstra, MD, PhD, FRCSC, CANADA Sarah Kerslake, BPhty, MSc, CANADA Daniel Stolear, MA, CANADA
The Prevalence Of Associated Anatomical Risk Factors For Patellofemoral Joint Pathology In Patients Undergoing Rotational Osteotomy And The Implication For The Level Of Correction. ePoster Presentation Martyn Snow, FRCS, UNITED KINGDOM Gwithyen Silk, FRCS, MRCS, MBChB, BA (Hons), MA, UNITED KINGDOM Mohammad Mahmoud Mohammad Mahmoud Haikal, MBChB , MSc(Orth), EGYPT
Patellar Dislocation During Examination Under Anesthesia As A Diagnostic Test For Patellar Instability: Data From Jupiter Cohort ePoster Presentation Shital N. Parikh, MD, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Matthew William Veerkamp, BA, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Eric J. Wall, MD, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES Philip Wilson, MD, UNITED STATES Ben E. Heyworth, MD, UNITED STATES Henry B. Ellis, MD, UNITED STATES Marc Tompkins, MD, UNITED STATES The JUPITER Group, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES
Three-Dimensional CT Bone Model Improves Interobserver Reliability of Trochlea Dysplasia Using the Dejour Classification in Patients with Patellar Dislocation ePoster Presentation Rika Shigemoto, MD, JAPAN Kanto Nagai, MD, PhD, JAPAN Kyohei Nishida , MD, PhD, JAPAN Kohei Kamada, MD, PhD, UNITED STATES Tetsuya Yamamoto, MD, PhD, JAPAN Yuta Nakanishi, MD, PhD, JAPAN Noriyuki Kanzaki, MD, PhD, JAPAN Yuichi Hoshino, MD, PhD, JAPAN Takehiko Matsushita, MD, PhD, JAPAN Ryosuke Kuroda, MD, PhD, JAPAN
Your Patella Dislocated: Will It Happen Again? An Assessment Of Mri Criteria For Recurrent Patella Dislocation After An Initial Event ePoster Presentation Mauricio Drummond, Jr., MD, UNITED STATES Jason Brenner, MS, UNITED STATES Steven Henick, MD, UNITED STATES Leila M. Alvandi, PhD, UNITED STATES Edina Gjonbalaj, BS, UNITED STATES Benjamin Levy, UNITED STATES Jacob Schulz, UNITED STATES Eric D. Fornari, MD, UNITED STATES
Factors Associated with the Decision to Perform a Lateral Retinacular Release or Lengthening During Medial Patellofemoral Ligament Reconstruction in the JUPITER Cohort ePoster Presentation Joshua T. Bram, MD, UNITED STATES Emilie Lijesen, BS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES Shae K Simpson, BS, UNITED STATES Ben E. Heyworth, MD, UNITED STATES Eric J. Wall, MD, UNITED STATES Adam B. Yanke, MD, UNITED STATES Jacqueline M. Brady, MD, UNITED STATES Lauren H Redler, MD, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES Shital N. Parikh, MD, UNITED STATES
Isolated Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability Regardless of Tibial Tubercle-Trochlear Groove Distance and Patellar Height: Differential Outcomes for Chondral Defects ePoster Presentation Michael Davies, MD, UNITED STATES Bennett Propp, BS, UNITED STATES William A. Marmor, MD, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Joseph T. Nguyen, MPH, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES Elizabeth Rose Dennis, MD MS, UNITED STATES
Outcomes of Skeletally Immature Patients Undergoing Isolated Medial Patellofemoral Ligament Reconstruction: Data from the JUPITER Cohort ePoster Presentation Lauren H Redler, MD, UNITED STATES Elizabeth Rose Dennis, MD MS, UNITED STATES Bennett Propp, BS, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Matthew William Veerkamp, BA, UNITED STATES Joseph T. Nguyen, MPH, UNITED STATES Eric J. Wall, MD, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES Shital N. Parikh, MD, UNITED STATES

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TT-TG Ratio Provides a More Accurate Estimation of the Amount of Tibial Tubercle Medialization Needed in Patellofemoral Instability

TT-TG Ratio Provides a More Accurate Estimation of the Amount of Tibial Tubercle Medialization Needed in Patellofemoral Instability

Introduction

Methods

Results

Conclusion

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TT-TG Ratio Provides a More Accurate Estimation of the Amount of Tibial Tubercle Medialization Needed in Patellofemoral Instability

TT-TG Ratio Provides a More Accurate Estimation of the Amount of Tibial Tubercle Medialization Needed in Patellofemoral Instability

Introduction

Methods

Results

Conclusion