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The tibial-tubercle trochlear groove distance in patients with trochlear dysplasia: the influence of the proximally flat trochlea.
[trochlear dysplasia]
Increased
tibial
tubercle
trochlear
groove
distance
(
TT-
TG
)
is
frequently
associated
with
trochlear
dysplasia
(
TD
)
.
Since
the
trochlear
groove
appears
more
distally
in
patients
with
TD
compared
to
controls
,
it
is
unknown
whether
TT-
TG
might
be
comparable
and
meaningful
.
Fifty
patients
with
TD
were
retrospectively
analysed
and
compared
to
52
age-
and
gender-matched
patients
(
CG
)
.
TT-
TG
was
measured
on
transverse
MR
images
,
as
the
distance
between
the
trochlear
groove
of
minimal
2
mm
depth
proximally
and
the
centre
of
the
patellar
tendon
at
its
distal
insertion
.
The
height
of
the
femoral
reference
point
above
joint
line
was
recorded
for
both
groups
.
TT-
TG
measurement
was
repeated
in
CG
using
the
first
(
P
25
)
,
second
(
P
50
)
and
third
quartile
(
P
75
)
above
joint
line
of
TD
.
Patients
with
TD
had
a
significantly
smaller
vertical
distance
between
the
most
proximal
trochlear
deepening
and
the
femorotibial
joint
line
(
20
.
6
mm
,
range
10
.
3
-
30
.
9
)
compared
to
CG
(
33
.
8
mm
,
range
25
.
4
-
41
.
1
;
p
<
0
.
001
)
.
TT-
TG
values
measured
at
20
mm
(
P
50
)
and
15
mm
(
P
25
)
proximal
to
the
femorotibial
joint
line
were
significantly
smaller
compared
when
measured
with
the
most
proximal
reference
point
[
1
.
8
mm
(
95
%
CI
1
.
3
-
2
.
3
,
p
<
0
.
001
)
and
2
.
4
mm
(
95
%
CI
1
.
9
-
3
.
0
,
p
<
0
.
001
)
]
in
CG
.
The
inter-rater
reliability
was
excellent
(
ICC
0
.
99
)
.
TT-
TG
distance
depends
significantly
on
the
femoral
reference
point
.
Since
the
trochlear
groove
is
seen
more
distally
in
patients
with
TD
compared
to
controls
,
TT-
TG
of
the
patients
with
highest
risk
of
recurrent
patellar
instability
might
be
underestimated
.
Diagnostic
study
,
Level
I
.
Diseases
Validation
Diseases presenting
"proximal trochlear"
symptom
trochlear dysplasia
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