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Current Reviews in Musculoskeletal Medicine

Erschienen in:

08.05.2018 | Advances in Patellofemoral Surgery (L Redler, Section Editor)

Use of TT-PCL versus TT-TG

verfasst von: Jacqueline M. Brady, Adam S. Rosencrans, Beth E. Shubin Stein

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 2/2018

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Abstract

Purpose of Review

The tibial tubercle-to-trochlear groove (TT-TG) distance and tibial tubercle-to-posterior cruciate ligament (TT-PCL) distance have both been proposed for use in the evaluation of patients with patellofemoral instability.

Recent Findings

While the TT-TG value may be confounded by several factors, including age, gender, body mass index, and varying degrees of knee flexion on cross-sectional imaging, recent literature supports its utility for differentiation of patients with and without patellofemoral instability, and stratification of patients with and without coronal malalignment. The TT-PCL describes pure lateralization of the tibial tubercle, and may be used in conjunction with the TT-TG to better understand the path taken by the extensor mechanism of the knee joint.

Summary

The TT-TG measurement is superior to the TT-PCL measurement for differentiating patients with patellofemoral instability from their stable counterparts, though TT-PCL may be useful in conjunction with TT-TG for better understanding the path of the extensor mechanism across the knee joint.

France L, Nester C. Effect of errors in the identification of anatomical landmarks on the accuracy of Q angle values. 2001;16:710–713.

Biedert RM, Gruhl C. Axial computed tomography of the patellofemoral joint with and without quadriceps contraction. Arch Orthop Trauma Surg. 1997;116(1–2):77–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9006771 CrossRefPubMed

Guerra JP, Arnold MJ, Gajdosik RL. Q angle: effects of isometric quadriceps contraction and body position. J Orthop Sports Phys Ther. 1994;19(4):200–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8173567 CrossRefPubMed

• Camp CL, Stuart MJ, Krych AJ, Levy BA, Bond JR, Collins MS, et al. CT and MRI measurements of tibial tubercle-trochlear groove distances are not equivalent in patients with patellar instability. Am J Sports Med. 2013 [cited 2014 Oct 29];41(8):1835–40. Available from: http://ajs.sagepub.com/cgi/content/short/41/8/1835. While both MRI and CT measurements of TT-TG distances were found to have high interrater reliability, the values were not equivalent, and the authors concluded that MRI might underestimate TT-TG compared to CT.

Yao L, Gai N, Boutin RD. Axial scan orientation and the tibial tubercle-trochlear groove distance: error analysis and correction. AJR Am J Roentgenol. 2014 Jun [cited 2014 Jun 12];202(6):1291–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24848827.

•• Brady JM, Sullivan JP, Nguyen J, Mintz D, Green DW, Strickland S, et al. The tibial tubercle–to–trochlear groove (TT-TG) distance is reliable in the setting of trochlear dysplasia, and superior to the tibial tubercle–to–posterior cruciate ligament (TT-PCL) distance when evaluating coronal malalignment in patellofemoral instabi. Arthrosc J Arthrosc Relat Surg. Arthroscopy Association of North America; 2017;1–9. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0749806317306369. Knee MRIs were compared for patients with ACL tears and patellofemoral instability. TT-TG distances were found to be reliable, even in the setting of trochlear dysplasia. TT-TG also differed significantly between the groups, while TT-PCL did not.

Wittstein J, O’Brien S, Vinson E, Garrett W Jr. MRI evaluation of anterior knee pain: predicting response to nonoperative treatment. Skeletal Radiol. 2009 Sep [cited 2014 Oct 30];38(9):895–901. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19381628.

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

Pandit S, Frampton C, Stoddart J, Lynskey T. Magnetic resonance imaging assessment of tibial tuberosity-trochlear groove distance: normal values for males and females. Int Orthop. 2011 Dec [cited 2014 Oct 28];35(12):1799–803. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3224621&tool=pmcentrez&rendertype=abstract.

10.

Seitlinger G, Scheurecker G, Högler R, Labey L, Innocenti B, Hofmann S. Tibial tubercle-posterior cruciate ligament distance: a new measurement to define the position of the tibial tubercle in patients with patellar dislocation. Am J Sports Med. 2012 May [cited 2014 Oct 28];40(5):1119–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22415209.

11.

Anley CM, Morris GV, Saithna A, James SL, Snow M. Defining the role of the tibial tubercle-trochlear groove and tibial tubercle-posterior cruciate ligament distances in the work-up of patients with patellofemoral disorders. Am J Sports Med. 2015;40(5):1119–25. Available from: http://journal.ajsm.org/cgi/doi/10.1177/0363546515576128

12.

Draganich LF, Andriacchi TP, Andersson GBJ. Interaction between intrinic knee mechanics and the knee extensor mechanism. J Orthop Res. 1987;5(8):539–47.CrossRefPubMed

13.

Kurosawa H, Walker P, Abe S, Garg A, Hunter T. Geometry and motion of the knee for implant and orthotic design. J Biomech. 1985;18(7):487–99.CrossRefPubMed

14.

Pinskerova V, Johal P, Nakagawa S, Sosna A, Williams A, Gedroyc W, et al. Does the femur roll-back with flexion? J Bone Joint Surg Br. 2004;86(6):925–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15330038 CrossRefPubMed

15.

el Nahass B, Madson MM, Walker P. Motion of the knee after condylar resurfacing—an in vivo study. J Biomech. 1991;24(12):1107–17.CrossRefPubMed

16.

Marquez-Lara A, Andersen J, Lenchik L, Ferguson CM, Gupta P. Variability in patellofemoral alignment measurements on MRI: influence of knee position. Am J Roentgenol. 2017;(May):1–6. Available from: http://www.ajronline.org/doi/10.2214/AJR.16.17007.

17.

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

18.

•• Camp CL, Heidenreich MJ, Dahm DL, Stuart MJ, Levy BA, Krych AJ. Individualizing the tibial tubercle – trochlear groove distance: patellar insability ratios that predict recurrent instability. Am J Sports Med. 2016;44(393):393–9. The authors proposed that TT-TG be measured in relation to size of the knee, in order to account for patient-specific anatomy. Their ratio-based measurements were found to better predict patellofemoral instability than TT-TG alone. CrossRefPubMed

19.

Hingelbaum S, Best R, Huth J, Wagner D, Bauer G, Mauch F. The TT-TG index: a new knee size adjusted measure method to determine the TT-TG distance. Knee Surg Sports Traumatol Arthrosc. 2014;22:2388–95.CrossRefPubMed

20.

Caton JH, Dejour D. Tibial tubercle osteotomy in patello-femoral instability and in patellar height abnormality. Int Orthop. 2010 Feb [cited 2014 Jun 26];34(2):305–9. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2899368&tool=pmcentrez&rendertype=abstract.

21.

• Redler LK, Meyers KN, Munch JL, Dennis ER, Nguyen JT, Shubin Stein BE. Anisometry of medial patellofemoral ligament reconstruction in the setting of patella alta and increased tibial tubercle-trochlear groove (TT-TG) distance. Abstr Present AOSSM 2016 Annu Meet Color Springs, CO. This biomechanical study demonstrated that isometry of an MPFL reconstruction worsened in the setting of coronal (high TT-TG) and sagittal (patella alta) malalignment of the knee. In addition, TT-TG and patella alta were found to have a synergicstic effect on each other: in the setting of patella alta, lower values of TT-TG measurements were found to induce anisometry of the graft.

22.

Daynes J, Hinckel B, Farr J. Tibial tuberosity-posterior cruciate ligament distance. J Knee Surg. 2016;29(6):471–7.CrossRefPubMed

23.

Clifton B, Richter DL, Tandberg D, Ferguson M, Treme G. Evaluation of the tibial tubercle to posterior cruciate ligament distance in a pediatric patient population. J Pediatr Orthop. 2017;1. Available from: http://insights.ovid.com/crossref?an=01241398-900000000-99048.

24.

Boutris N, Delgado DA, Labis JS, McCulloch PC, Lintner DM, Harris JD. Current evidence advocates use of a new pathologic tibial tubercle–posterior cruciate ligament distance threshold in patients with patellar instability. Knee Surg Sport Traumatol Arthrosc. Springer Berlin Heidelberg; 2017;(123456789):1–10.

25.

•• Heidenreich MJ, Camp CL, Dahm DL, Stuart MJ, Levy BA, Krych AJ. The contribution of the tibial tubercle to patellar instability: analysis of tibial tubercle???trochlear groove (TT-TG) and tibial tubercle???posterior cruciate ligament (TT-PCL) distances. Knee Surgery, Sport Traumatol Arthrosc. Springer Berlin Heidelberg; 2015;4–8. TT-PCL is higher in patients with patellar instability, but the range of values is broad. The authors recommend utilizing the TT-PCL measurement for patients who have a normal TT-TG but ongoing patellar instability.

26.

Lewallen L, Mcintosh A, Dahm D. First-time patellofemoral dislocation: risk factors for recurrent instability. J Knee Surg. 2015;28(4):303–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25633361 CrossRefPubMed

Titel: Use of TT-PCL versus TT-TG
verfasst von: Jacqueline M. Brady
Adam S. Rosencrans
Beth E. Shubin Stein
Publikationsdatum: 08.05.2018
Verlag: Springer US
Erschienen in: Current Reviews in Musculoskeletal Medicine / Ausgabe 2/2018
Elektronische ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-018-9481-4

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Recent Findings

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