001), and it was signficantly negatively correlated with trochlear groove medialization ( r = −0.178 P =. Increased TT-TG distance was significantly positively correlated with TTL ( r = 0.376 P <. The LPD and control groups differed significantly in TT-TG distance, TTL, TFR, and MAD ( P <. 05 and r ≥ 0.30 were analyzed via stepwise multivariable linear regression analysis to predict TT-TG distance. The Pearson correlation coefficient ( r) was calculated to evaluate the association between increased TT-TG distance and its anatomical parameters, and factors that met the inclusion criteria of P <. The 2 groups were compared in TT-TG distance and its related anatomical components: tibial tubercle lateralization (TTL), trochlear groove medialization, femoral anteversion, tibiofemoral rotation (TFR), tibial torsion, and mechanical axis deviation (MAD). Included were 80 patients with recurrent LPD and 80 age- and body mass index–matched controls. To (1) determine the anatomical components related to increased TT-TG distance and (2) quantify the contribution of each to identify the most prominent component.Ĭase-control study Level of evidence, 3. Changes to TT-TG distance are determined by a combination of several anatomical factors. Increased tibial tuberosity–trochlear groove (TT-TG) distance is an important indicator of medial tibial tubercle transfer in the surgical management of lateral patellar dislocation (LPD). Overmedialization of the tibial tuberosity should be avoided in the varus knee, the knee after medial meniscectomy, and the knee with preexisting degenerative arthritis of the medial compartment. The results of our study suggest that caution should be used when transferring a patellar tendon in the face of a preexisting normal Q angle as this will result in abnormally high peak pressure within the tibiofemoral joint. Medial displacement of the tibial tuberosity also significantly increased the average contact pressure of the medial tibiofemoral compartment and changed the balance of tibiofemoral joint loading. Medialization of the tibial tuberosity significantly increased the patellofemoral contact pressure. All native intact knee specimens had a normal Q angle. Peak pressures, average contact pressures, and contact areas of the patellofemoral and tibiofemoral joints were calculated on native intact knee specimens and after tibial tuberosity transfer.
Static intrajoint loads were recorded using Fuji Prescale pressure-sensitive film for contact pressure and contact area determination in a closed kinetic chain knee testing protocol. In this study, six fresh human cadaveric knees were used. Medial transfer of the tibial tuberosity has been commonly used for treatment of recurrent dislocation of the patella and patellofemoral malalignment.
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