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Tibial tubercle–trochlear groove distance and angle are higher in children with patellar instability

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to assess the variations in tibial tubercle–trochlear groove distance and angle as a function of age and gender in a population of children without patellar instability (PI) compared with those with PI.

Methods

A retrospective review of 869 children’s knee MRIs, ages 5 to 15 years, were evaluated using a control group (792 children) without evidence of PI and a group with PI (77 children). Tibial tubercle–trochlear groove distance (TT–TGd) and angle (TT–TGa) were measured twice by two readers to assess intra- and inter-observer reliability and compared between PI and control groups. In both groups, functions of age and gender on TT–TGd and TT–TGa values were evaluated.

Results

Both TT–TGd and TT–TGa measurements showed excellent intra- and inter-observer reliability. The mean TT–TGd for the PI group was 17.2 mm (SD 6.6) and significantly higher than the mean TT–TGd for the control group (10.4 SD 3.8 mm, P = 0.001). The mean TT–TGa for the PI was 20.8° (SD 8.3°), which was also significantly higher than the mean TT–TGa for the control group (12.5° SD 4.6°, P < 0.001). Control group revealed a positive correlation between age and TT–TGd measurements (r = 0.243, P < 0.001). The mean TT–TGa for girls (13.3° SD 4.7°) was higher than the mean TT–TGa for boys (11.9° SD 4.4°) in the control group (P < 0.001).

Conclusion

TT–TGa and TT–TGd are reliable and can be used for the evaluation of the extansor mechanism alignment in children with and without PI. However, it must be considered that TT–TGd is increasing in growing patients. Soft-tissue procedures may be prone to failure, since bony procedures for patellar alignment cannot be done until skeletal maturity.

Level of evidence

III.

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Funding

No funding has been received for this study.

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Authors and Affiliations

  1. Department of Orthopedics, Health Science University Baltalimani Bone Diseases Education and Research Hospital, Rumeli Hisari Sok. No 62 34470, Baltalimani Sariyer, Istanbul, Turkey

    Ilhan A. Bayhan, Akay Kirat, Yakup Alpay, Baris Ozkul & Deniz Kargin

Authors
  1. Ilhan A. Bayhan
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  2. Akay Kirat
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  3. Yakup Alpay
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  4. Baris Ozkul
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  5. Deniz Kargin
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Corresponding author

Correspondence to Ilhan A. Bayhan.

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Conflict of interest

The authors have no conflict of interest.

Ethical approval

This study was approved by Baltalimani Bone Diseases Education and Research Hospital Institutional Review Board (03.08.2017/12).

Informed consent

Informed consent was waived, because the study was a retrospective cross-sectional review.

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Bayhan, I.A., Kirat, A., Alpay, Y. et al. Tibial tubercle–trochlear groove distance and angle are higher in children with patellar instability. Knee Surg Sports Traumatol Arthrosc 26, 3566–3571 (2018). https://doi.org/10.1007/s00167-018-4997-0

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  • DOI: https://doi.org/10.1007/s00167-018-4997-0

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