Overcoming Limitations in Tibial Tubercle-Trochlear Groove Distance Measurement: A Study of Its Reproducibility and Reliability in High-Grade Trochlear Dysplasia.
Lucia Angelelli, David Mazy, Nicolas Cance, Tomas Pineda, Edoardo Giovannetti de Sanctis, David H Dejour
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引用次数: 0
Abstract
Background: In cases of high-grade trochlear dysplasia, identifying the reference point of the trochlear groove can be challenging when measuring the tibial tubercle-trochlear groove (TT-TG) distance.
Purpose/hypothesis: The purpose of this study is to evaluate the reliability of TT-TG measurements obtained at different trochlear reference levels. It was hypothesized that TT-TG measurements would remain feasible even in cases of high-grade trochlear dysplasia when alternative trochlear reference levels are used.
Study design: Cross-sectional study; Level of evidence, 3.
Methods: A retrospective analysis of magnetic resonance imaging scans from patients presenting with patellar instability between 2019 and 2023 was performed. For each patient, the TT-TG distance was measured at 3 levels on axial magnetic resonance imaging: high (hTT-TG), middle (mTT-TG), and low (lTT-TG). The TT-posterior cruciate ligament (TT-PCL) distance was also measured. TT-TG values were compared across the 3 reference levels. Inter- and intraobserver reliability were assessed using the intraclass correlation coefficient (ICC).
Results: A total of 136 knees were included, of which 64% presented with high-grade trochlear dysplasia (37 Dejour type B and 50 type D). No statistically significant differences were observed between TT-TG measurements obtained at the 3 reference levels. The hTT-TG could be measured in 115 of 136 knees. Among the 21 knees in which hTT-TG could not be measured, 16 were associated with Dejour type D dysplasia, 1 with type C, 3 with type B, and 1 with type A dysplasia. The lTT-TG was measurable in all patients. Interobserver ICC values were good and excellent for lTT-TG, mTT-TG, and hTT-TG (0.877, 0.929, and 0.892, respectively), and intraobserver ICC values were also excellent (0.976, 0.976, and 0.954, respectively). The interobserver reliability for TT-PCL was moderate (ICC, 0.606), whereas intraobserver reliability remained excellent (ICC, 0.925).
Conclusion: TT-TG measurements remained feasible and reproducible in this cohort of patients with patellar instability, including a high proportion of high-grade trochlear dysplasia, when a slightly more distal trochlear reference level was used. TT-PCL remains a potential alternative although its interobserver reliability was lower than that of TT-TG in the present study.
期刊介绍：
The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty.
Topics include original research in the areas of:
-Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries
-Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot)
-Relevant translational research
-Sports traumatology/epidemiology
-Knee and shoulder arthroplasty
The OJSM also publishes relevant systematic reviews and meta-analyses.
This journal is a member of the Committee on Publication Ethics (COPE).
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