Li Kehan, Xu Chenyue, Dong Zhenyue, Ji Gang, Wang Fei
Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Orthop J Sports Med. 2024 Apr 9;12(4):23259671241239965. doi: 10.1177/23259671241239965. eCollection 2024 Apr.
The tibial tubercle-trochlear groove (TT-TG) distance is a measurement used to quantitatively assess tibial tubercle lateralization (TTL), and it has important reference value for the treatment of patellar dislocation (PD). However, TT-TG distance accuracy has been questioned, so many new parameters have been proposed.
To compare which of the TT-TG, tibial tubercle-midepicondyle (TT-ME), tibial tubercle-Roman arch (TT-RA), tibial tubercle-tibial intercondylar midpoint (TT-TIM), and tibial tubercle-mid inter-epicondyle trochlea intersection (TT-MIELTI) distances better reflect TTL in patients with PD.
Cohort study (diagnosis); Level of evidence, 3.
A total of 96 patients who had undergone surgery for PD and 96 patients without PD (controls) were included in the study. The patients had all undergone computed tomography examination. The TT-TG, TT-ME, TT-RA, TT-TIM, TT-MIELTI distances and the TTL distance were measured independently by 2 surgeons in a blinded and randomized fashion. The test was used to detect whether the parameters were significantly different between the 2 groups. The TTL distance was used as a reference value for lateralization of tibial tubercle. Pearson correlation coefficients were calculated to determine correlations between the defined measurements.
The intra- and interobserver reliability of the defined measurements was excellent. All parameters except for TT-TIM distance were significantly larger in the PD group than the control group ( < .01 for all). There was a moderate correlation ( = 0.601) between the TT-TG distance and TTL, and other parameters were less correlated with TTL.
Among 5 the parameters tested, the TT-TG distance still had the highest correlation with TTL and was able to reflect TTL better in patients with PD. The role of TT-TIM distance in the assessment of PD needs further study.
胫骨结节-滑车沟（TT-TG）距离是用于定量评估胫骨结节外侧化（TTL）的一种测量方法，对髌骨脱位（PD）的治疗具有重要参考价值。然而，TT-TG距离的准确性受到质疑，因此提出了许多新参数。
比较TT-TG、胫骨结节-内上髁（TT-ME）、胫骨结节-罗马弓（TT-RA）、胫骨结节-胫骨髁间中点（TT-TIM）和胫骨结节-髁间滑车中点交点（TT-MIELTI）距离中哪一个能更好地反映PD患者的TTL。
队列研究（诊断）；证据等级，3级。
本研究共纳入96例行PD手术的患者和96例无PD的患者（对照组）。所有患者均接受了计算机断层扫描检查。2名外科医生以盲法和随机方式独立测量TT-TG、TT-ME、TT-RA、TT-TIM、TT-MIELTI距离以及TTL距离。采用检验检测两组之间参数是否存在显著差异。将TTL距离用作胫骨结节外侧化的参考值。计算Pearson相关系数以确定所定义测量值之间的相关性。
所定义测量值的观察者内和观察者间可靠性极佳。除TT-TIM距离外，PD组所有参数均显著大于对照组（所有P均<0.01）。TT-TG距离与TTL之间存在中度相关性（r = 0.601），其他参数与TTL的相关性较低。
在测试的5个参数中，TT-TG距离与TTL的相关性仍然最高，并且能够更好地反映PD患者的TTL。TT-TIM距离在PD评估中的作用需要进一步研究。
