Correlation of the tibial tuberosity–trochlear groove distance with the Q-angle

Dickschas, Jörg; Harrer, Jörg; Bayer, Thomas A.; Schwitulla, Judith; Strecker, W.

doi:10.1007/s00167-014-3426-2

Cited by 49 publications

(37 citation statements)

References 38 publications

(44 reference statements)

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“…On the contrary, the surgeon must be aware, that a valgus deformity in the frontal plane may imply an increased TT-TG value on axial MRI scans, which, however, has no pathological influence, once the varization osteotomy is performed. 25 Therefore, it is crucial to closely reevaluate patellar tracking by direct arthroscopical visualization, after each particular procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The tibial tuberosity to trochlear groove (TT-TG) distance was measured on axial MRI scans of the knee according to Schoettle et al 22 A distance of 16 mm or more was considered pathological and indicative for a tibial tubercle transfer to physiological values, if accompanied by persisting patellar maltracking, after DFO was performed. [23][24][25] The effect of each particular procedure on patellar tracking was arthroscopically reevaluated, throughout the surgery. The common scoring systems-Visual analogue pain scale (VAS), Kujala's anterior knee pain score, Lysholm score, and Tegner activity indexwere determined preoperatively and at the time of followup.…”

Section: Fig 2 (A)mentioning

confidence: 99%

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Clinical Results after Combined Distal Femoral Osteotomy in Patients with Patellar Maltracking and Recurrent Dislocations

et al. 2018

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The purpose of this study is to analyze the clinical results after treatment of patellofemoral instability and maltracking caused by torsional or axial deformities of the lower extremity by combined distal femoral osteotomies (DFOs). We analyzed 31 DFOs (25 patients) with patellar maltracking and instability, treated in our clinic. Torsional angles and the leg axis in the frontal plane were measured preoperatively. Standardized scoring systems were determined pre- and postoperatively including a clinical examination. Nineteen cases of torsional and 12 cases of axis deformities were evaluated 27 (12–64) months postoperatively. Among those with torsional deformity, mean femoral torsion was –39.0 ± 8.8 degrees, tibial tuberosity to trochlear groove (TT-TG) 20.3 ± 4.5 mm. We performed 19 torsional (+11.4 ± 2.4 degrees) DFOs with medial patellofemoral ligament (MPFL) augmentation (n = 19), tibial tuberosity transfer (n = 14, 10.9 ± 6.0 mm), varus (n = 4, 3.3 ± 1.0 degrees), or valgus (n = 1, 7.0 degrees) correction. Among valgus deformities, the leg axis was 6.7 ± 2.3 degrees valgus and TT-TG 19.3 ± 5.0 mm. We performed 12 medially closing-wedge DFOs (7.6 ± 2.8 degrees) with MPFL augmentation (n = 12) and tibial tubercle transfer (n = 9, 11.4 ± 7.3 mm). Visual analogue pain scale improved from 6.2 to 1.5 (p = 0.000), Kujala score from 45.0 to 81.5 (p = 0.000), Lysholm score from 40.3 to 83.9 (p = 0.000), and Tegner score from 2.1 to 3.9 (p = 0.000). Preoperative cartilage damage significantly influences the postoperative functional outcome (Lysholm score) (p = 0.026) as well as the improvement in terms of the Kujala score (p = 0.045) in the overall collective. No redislocation was observed. Patellofemoral maltracking and instability in torsional and axis deformities can successfully be treated by combined DFOs with excellent clinical results. The coexistence of risk factors for patellar instability requires a combination of additional procedures to complement the osteotomy. Preoperative cartilage lesions significantly influence the clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Fig 2 (A)mentioning

confidence: 99%

Clinical Results after Combined Distal Femoral Osteotomy in Patients with Patellar Maltracking and Recurrent Dislocations

et al. 2018

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“…Moreover, in that way, we do not change the Q angle at all, which is also important in patellofemoral tracking. 22 These points could be issues with other techniques such as complete osteotomy of the anterior tibial tubercle that presents the possibility of nonunion or an iatrogenic change in the Q angle. 23 Furthermore, our technique does not require any autografts and needs few and inexpensive devices to fix the tendon.…”

Section: Discussionmentioning

confidence: 99%

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja

Perelli

Ibáñez

Marin

et al. 2020

Arthroscopy Techniques

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Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritisdeven more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar tendon with allograft, and proximalization of the tibial tubercle. A combination of 2 or more of these treatments may be recommended in cases of significant patella baja. We present a simple and reproducible technique to address patella baja that combines a partial transposition of the tibial tubercle and patellar tendon lengthening using a subperiosteal patellar flap in continuity with the patellar tendon.

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“…In congenital deformities patellofemoral maltracking can be caused by increased femoral internal and/or tibial external torsion 9 moreover, symptoms of the hip by increased femoral external or internal torsional deformity. 10 Femoral external torsional deformities can also cause anterior knee pain, even though this is rare in congenital cases. It has not been reported so far, whether increased tibial internal torsion can lead to patellofemoral symptoms.…”

Section: Symptomsmentioning

confidence: 99%

Torsional Osteotomy

et al. 2019

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This article provides an overview of symptomatic torsional deformities of the lower extremity, and operative treatment techniques are described in detail. A definition of torsion versus rotation as well as information to physical examination and the relevance of radiological evaluation is given. Based on current literature and the own personal experience of the authors in osteotomies, surgical techniques at the proximal and at the distal femur, as well as at the tibia are presented.

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Correlation of the tibial tuberosity–trochlear groove distance with the Q-angle

Abstract: Diagnostic study, Level III.

Cited by 49 publications

References 38 publications

Clinical Results after Combined Distal Femoral Osteotomy in Patients with Patellar Maltracking and Recurrent Dislocations

Clinical Results after Combined Distal Femoral Osteotomy in Patients with Patellar Maltracking and Recurrent Dislocations

Patellar Tendon Lengthening: Rescue Procedure for Patella Baja

Torsional Osteotomy

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