Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents
Abstract Background Measurement of the tibial tubercle–trochlear groove (TT–TG) distance is used to assess patellofemoral instability and rotation. Since patellofemoral instability and acute patellar dislocation are common among adolescents, it is important to clarify the relationship between TT–TG...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-08-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40634-018-0149-1 |
| _version_ | 1797225677587480576 |
|---|---|
| author | Juha-Sampo Suomalainen Gideon Regalado Antti Joukainen Tommi Kääriäinen Mervi Könönen Hannu Manninen Petri Sipola Hannu Kokki |
| author_facet | Juha-Sampo Suomalainen Gideon Regalado Antti Joukainen Tommi Kääriäinen Mervi Könönen Hannu Manninen Petri Sipola Hannu Kokki |
| author_sort | Juha-Sampo Suomalainen |
| collection | DOAJ |
| description | Abstract Background Measurement of the tibial tubercle–trochlear groove (TT–TG) distance is used to assess patellofemoral instability and rotation. Since patellofemoral instability and acute patellar dislocation are common among adolescents, it is important to clarify the relationship between TT–TG distance and various flexion and extension angles in asymptomatic children. The purpose of the present study was to determine how knee flexion and extension influence TT–TG-distance values measured using 3D imaging in an anatomic axial plane among asymptomatic adolescents. Methods We performed magnetic resonance imaging (MRI) of 26 knees in 13 adolescents (8 boys and 5 girls) of 11–17 years of age, with no known patellofemoral disorders. Imaging was performed with 3.0 T MRI with the knee at four separate angles of flexion between 0° and 30°. Measurements were made by two independent blinded raters. Results The mean TT–TG distance in millimetres was 11.1–0.29 × the angle in degrees. TT–TG distance decreased with greater flexion, showing a mean decrease of 0.29 mm (SD, 0.04) per degree of increased flexion (p < 0.001). We found significant inter-observer (Pearson’s r = 0.636, p = 0.03) and intra-observer (Pearson’s r = 0.792, p ≤ 0.001) correlations. TT–TG values were not significantly correlated with age, length, weight, or body mass index. The rate of TT–TG change (change between consecutive TT–TG values/change between consecutive angles) was significantly negatively correlated with length (p = 0.014), weight (p = 0.004), and body mass index (p = 0.025). Conclusions Our data revealed that TT–TG distance assessed in the anatomic axial plane decreased with greater flexion in adolescent. Moreover, this effect of knee angle was stronger in smaller subjects. These findings support the need for a standardized protocol for TT–TG distance measurement in adolescents. |
| first_indexed | 2024-03-08T08:33:12Z |
| format | Article |
| id | doaj.art-492d4342d0384bbf9bf0219e69a92bb6 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-24T14:12:49Z |
| publishDate | 2018-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-492d4342d0384bbf9bf0219e69a92bb62024-04-03T08:58:03ZengWileyJournal of Experimental Orthopaedics2197-11532018-08-01511610.1186/s40634-018-0149-1Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescentsJuha-Sampo Suomalainen0Gideon Regalado1Antti Joukainen2Tommi Kääriäinen3Mervi Könönen4Hannu Manninen5Petri Sipola6Hannu Kokki7Department of Clinical Radiology, Kuopio University HospitalDepartment of Orthopaedics and Traumatology, Kuopio University HospitalDepartment of Orthopaedics and Traumatology, Kuopio University HospitalDepartment of Orthopaedics and Traumatology, Kuopio University HospitalDepartment of Clinical Radiology, Kuopio University HospitalDepartment of Clinical Radiology, Kuopio University HospitalDepartment of Clinical Radiology, Kuopio University HospitalSchool of Medicine, University of Eastern FinlandAbstract Background Measurement of the tibial tubercle–trochlear groove (TT–TG) distance is used to assess patellofemoral instability and rotation. Since patellofemoral instability and acute patellar dislocation are common among adolescents, it is important to clarify the relationship between TT–TG distance and various flexion and extension angles in asymptomatic children. The purpose of the present study was to determine how knee flexion and extension influence TT–TG-distance values measured using 3D imaging in an anatomic axial plane among asymptomatic adolescents. Methods We performed magnetic resonance imaging (MRI) of 26 knees in 13 adolescents (8 boys and 5 girls) of 11–17 years of age, with no known patellofemoral disorders. Imaging was performed with 3.0 T MRI with the knee at four separate angles of flexion between 0° and 30°. Measurements were made by two independent blinded raters. Results The mean TT–TG distance in millimetres was 11.1–0.29 × the angle in degrees. TT–TG distance decreased with greater flexion, showing a mean decrease of 0.29 mm (SD, 0.04) per degree of increased flexion (p < 0.001). We found significant inter-observer (Pearson’s r = 0.636, p = 0.03) and intra-observer (Pearson’s r = 0.792, p ≤ 0.001) correlations. TT–TG values were not significantly correlated with age, length, weight, or body mass index. The rate of TT–TG change (change between consecutive TT–TG values/change between consecutive angles) was significantly negatively correlated with length (p = 0.014), weight (p = 0.004), and body mass index (p = 0.025). Conclusions Our data revealed that TT–TG distance assessed in the anatomic axial plane decreased with greater flexion in adolescent. Moreover, this effect of knee angle was stronger in smaller subjects. These findings support the need for a standardized protocol for TT–TG distance measurement in adolescents.http://link.springer.com/article/10.1186/s40634-018-0149-1Kinematic malalignmentPatellofemoral instabilityPatellar dislocationTibial tubercle–trochlear groove distanceMagnetic resonance imaging |
| spellingShingle | Juha-Sampo Suomalainen Gideon Regalado Antti Joukainen Tommi Kääriäinen Mervi Könönen Hannu Manninen Petri Sipola Hannu Kokki Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents Journal of Experimental Orthopaedics Kinematic malalignment Patellofemoral instability Patellar dislocation Tibial tubercle–trochlear groove distance Magnetic resonance imaging |
| title | Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents |
| title_full | Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents |
| title_fullStr | Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents |
| title_full_unstemmed | Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents |
| title_short | Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents |
| title_sort | effects of knee flexion and extension on the tibial tuberosity trochlear groove tt tg distance in adolescents |
| topic | Kinematic malalignment Patellofemoral instability Patellar dislocation Tibial tubercle–trochlear groove distance Magnetic resonance imaging |
| url | http://link.springer.com/article/10.1186/s40634-018-0149-1 |
| work_keys_str_mv | AT juhasamposuomalainen effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT gideonregalado effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT anttijoukainen effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT tommikaariainen effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT mervikononen effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT hannumanninen effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT petrisipola effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents AT hannukokki effectsofkneeflexionandextensiononthetibialtuberositytrochleargroovetttgdistanceinadolescents |