Prakash Jatin, Seon Jong-Keun, Ahn Hyeon-Woon, Cho Kyu-Jin, Im Chae-Jin, Song Eun Kyoo
Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Clin Orthop Surg. 2018 Dec;10(4):420-426. doi: 10.4055/cios.2018.10.4.420. Epub 2018 Nov 21.
The tibial tuberosity-trochlear groove (TT-TG) distance is used to determine the necessity of tibial tubercle osteotomy. We conducted this study to determine the extent to which each of the tibial tuberosity lateralization, trochlear groove medialization, and knee rotation angle affects the TT-TG distance in both normal and patella dislocated patients and thereby scrutinize the rationale for tuberosity transfer based on the TT-TG distance.
Retrospective analysis of rotational profile computed tomography was done for patella dislocated and control group patients. Femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization were assessed in all patients. Relationship of these parameters with the TT-TG distance was investigated to evaluate their effects on the TT-TG distance.
We observed that the patellar dislocation group, compared to the control group, had increased TT-TG distance (mean, 19.05 mm vs. 9.02 mm) and greater tuberosity lateralization (mean, 64.1% vs. 60.7%) and tibial external rotation in relation to the femur (mean, 7.9° vs. -0.81°).
Tuberosity lateralization and knee rotation were factors affecting patellar dislocation. These factors should be considered in addition to the TT-TG distance to determine the need for tibial tubercle osteotomy in patients with patellar dislocation.
胫骨结节-滑车沟（TT-TG）距离用于确定胫骨结节截骨术的必要性。我们开展这项研究以确定在正常和髌骨脱位患者中，胫骨结节外移、滑车沟内移以及膝关节旋转角度各自对TT-TG距离的影响程度，从而审视基于TT-TG距离进行结节移位的理论依据。
对髌骨脱位患者和对照组患者的旋转位计算机断层扫描进行回顾性分析。评估所有患者的股骨前倾、胫骨扭转、膝关节旋转角度、结节外移和滑车沟内移情况。研究这些参数与TT-TG距离的关系，以评估它们对TT-TG距离的影响。
我们观察到，与对照组相比，髌骨脱位组的TT-TG距离增加（平均值分别为19.05毫米和9.02毫米），结节外移程度更大（平均值分别为64.1%和60.7%），且胫骨相对于股骨的外旋角度更大（平均值分别为7.9°和-0.81°）。
结节外移和膝关节旋转是影响髌骨脱位的因素。在确定髌骨脱位患者是否需要进行胫骨结节截骨术时，除了TT-TG距离外，还应考虑这些因素。
