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Measurement of tibial tuberosity-trochlear groove distance: evaluation of inter- and intraobserver correlation dependent on the severity of trochlear dysplasia.
[trochlear dysplasia]
Excessive
tibial
tuberosity-trochlear
groove
distance
(
TT-
TG
)
is
considered
as
one
of
the
major
risk
factors
in
patellofemoral
instability
(
PFI
)
.
TT-
TG
characterises
the
lateralisation
of
the
tibial
tuberosity
and
the
medialisation
of
the
trochlear
groove
in
the
case
of
trochlear
dysplasia
.
The
aim
of
this
study
was
to
assess
the
inter-
and
intraobserver
reliability
of
the
measurement
of
TT-
TG
dependent
on
the
grade
of
trochlear
dysplasia
.
Magnetic
resonance
imaging
(
MRI
)
scans
of
99
consecutive
knee
joints
were
analysed
retrospectively
.
Hereof
,
61
knee
joints
presented
with
a
history
of
PFI
and
38
had
no
symptoms
of
PFI
.
After
synopsis
of
the
axial
MRI
scans
with
true
lateral
radiographs
of
the
knee
,
the
61
knees
presenting
with
PFI
were
assessed
in
terms
of
trochlear
dysplasia
.
The
knees
were
distributed
according
to
the
four
-
type
classification
system
described
by
Dejour
.
Regarding
interobserver
correlation
for
the
measurements
of
TT-
TG
in
trochlear
dysplasia
,
we
found
r
=
0
.
89
(
type
A
)
,
r
=
0
.
90
(
type
B
)
,
r
=
0
.
74
(
type
C
)
and
0
.
62
(
type
D
)
for
Pearson
's
correlation
coefficient
.
Regarding
intraobserver
correlation
,
we
calculated
r
=
0
.
89
(
type
A
)
,
r
=
0
.
91
(
type
B
)
,
r
=
0
.
77
(
type
C
)
and
r
=
0
.
71
(
type
D
)
,
respectively
.
Pearson
's
correlation
coefficient
for
the
measurement
of
TT-
TG
in
normal
knees
resulted
in
r
=
0
.
87
for
interobserver
correlation
and
r
=
0
.
90
for
intraobserver
correlation
.
Decreasing
inter-
and
intraobserver
correlation
for
the
measurement
of
TT-
TG
with
increasing
severity
of
trochlear
dysplasia
was
detected
.
In
our
opinion
,
the
measurement
of
TT-
TG
is
of
significance
in
low
-grade
trochlear
dysplasia
.
The
final
decision
to
perform
a
distal
realignment
procedure
based
on
a
pathological
TT-
TG
in
the
presence
of
high
-grade
trochlear
dysplasia
should
be
reassessed
properly
.
Retrospective
study
,
Level
II
.
Diseases
Validation
Diseases presenting
"tibial tuberosity"
symptom
trochlear dysplasia
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