Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medicine, Göttingen, Germany.
Am J Sports Med. 2011 Aug;39(8):1756-61. doi: 10.1177/0363546511404883. Epub 2011 May 12.
A lateralized tibial tubercle may be a relevant anatomic factor in patients with patellar instability and can be used as an indication for a distal realignment procedure. However, parameter values for the tibial tuberosity-trochlear groove (TT-TG) distance in the young patient have not been defined. It also remains to be determined how this parameter contributes to patellar instability in the growing knee joint.
The purpose of this study was to evaluate the value of the TT-TG distance in patellar instability in the young athlete.
Case control study; Level of evidence, 3.
Knee magnetic resonance images were collected from 109 patients with lateral patellar instability and from 136 control subjects. Student t test and multiple logistic regression analysis were used to compare the absolute and relative values of the TT-TG distance between patients and controls. The relative value was defined as the ratio between the TT-TG distance and the total width of the distal femur.
The TT-TG distance (absolute and relative to femur width) differed significantly between patients with patellar dislocation and the control group (both P < .01). The TT-TG distances were on average 4 mm larger in patients with patellar dislocation; TT-TG distance divided by femur width was on average 5% larger in patients with patellar dislocation. Multiple logistic regression analysis confirmed the TT-TG distance as a significant risk factor for patellar dislocation (P = .04), but showed no significant interaction with patient age or femur width (P = .95 and P = .15, respectively).
A lateralized tibial tubercle is a relevant anatomic factor in the young athlete and in the adult patient with lateral patellar instability. Its parameter values and its influence on patellar dislocation are independent of patient age and should therefore be evaluated as in adults.
外侧化的胫骨结节可能是髌股关节不稳定患者的一个相关解剖因素，可作为进行胫骨结节远端调整术的指征。然而，对于年轻患者的胫骨结节-滑车沟（TT-TG）距离的参数值尚未确定。此外，该参数如何影响生长膝关节的髌股关节不稳定仍有待确定。
本研究旨在评估 TT-TG 距离在年轻运动员髌股关节不稳定中的价值。
病例对照研究；证据水平，3 级。
收集了 109 例外侧髌股关节不稳定患者和 136 例对照者的膝关节磁共振成像。采用 Student t 检验和多因素逻辑回归分析比较患者和对照组之间 TT-TG 距离的绝对值和相对值。相对值定义为 TT-TG 距离与股骨远端总宽度的比值。
髌脱位患者与对照组之间 TT-TG 距离（绝对值和相对股骨宽度）差异有统计学意义（均 P <.01）。髌脱位患者的 TT-TG 距离平均大 4 mm；TT-TG 距离除以股骨宽度平均大 5%。多因素逻辑回归分析证实 TT-TG 距离是髌脱位的显著危险因素（P =.04），但与患者年龄或股骨宽度无显著交互作用（P =.95 和 P =.15）。
外侧化的胫骨结节是年轻运动员和外侧髌股关节不稳定成年患者的一个相关解剖因素。其参数值及其对髌脱位的影响与患者年龄无关，因此应像成人一样进行评估。
