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J Knee Surg 2022; 35(14): 1571-1576
DOI: 10.1055/s-0041-1729547
Original Article

Interobserver Reliability and Change in the Sagittal Tibial Tubercle–Trochlear Groove Distance with Increasing Knee Flexion Angles

Ian S. MacLean
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Taylor M. Southworth
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Ian J. Dempsey
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Neal B. Naveen
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Hailey P. Huddleston
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Drew A. Lansdown
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
,
Adam B. Yanke
1   Midwest Orthopaedics, Rush Orthopedic Surgery, Chicago, Illinois
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Abstract

The tibial tubercle–trochlear groove (TT-TG) distance is currently utilized to evaluate knee alignment in patients with patellar instability. Sagittal plane pathology measured by the sagittal tibial tubercle–trochlear groove (sTT-TG) distance has been described in instability but may also be important to consider in patients with cartilage injury. This study aims to (1) describe interobserver reliability of the sTT-TG distance and (2) characterize the change in the sTT-TG distance with respect to changing knee flexion angles. In this cadaveric study, six nonpaired cadaveric knees underwent magnetic resonance imaging (MRI) studies at each of the following degrees of knee flexion: −5, 0, 5, 10, 15, and 20. The sTT-TG distance was measured on the axial T2 sequence. Four reviewers measured this distance for each cadaver at each flexion angle. Intraclass correlation coefficients were calculated to determine interobserver reliability and reproducibility of the sTT-TG measurement. Analysis of variance (ANOVA) tests and Friedman's tests with a Bonferroni's correction were performed for each cadaver to compare sTT-TG distances at each flexion angle. Significance was defined as p < 0.05. There was excellent interobserver reliability of the sTT-TG distance with all intraclass correlation coefficients >0.9. The tibial tubercle progressively becomes more posterior in relation to the trochlear groove (more negative sTT-TG distance) with increasing knee flexion. The sTT-TG distance is a measurement that is reliable between attending surgeons and across training levels. The sTT-TG distance is affected by small changes in knee flexion angle. Awareness of knee flexion angle on MRI is important when this measurement is utilized by surgeons.

Keywords

patellofemoral - tibial tubercle osteotomy - sagittal tibial tubercle–trochlear groove distance - cartilage - knee imaging


Publication History

Received: 25 May 2020

Accepted: 12 March 2021

Article published online:
01 May 2021

© 2021. Thieme. All rights reserved.

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