Blog
About

1
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Comment on: Patellar instability in Indian population: relevance of tibial tuberosity and trochlear groove distance : SICOT J 2016, 2, 14, DOI: 10.1051/sicotj/2016008

      1 , 2 , *

      SICOT-J

      EDP Sciences

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Dear editor, We were interested in reading “Patellar instability in Indian population: relevance of tibial tuberosity and trochlear groove distance” by Sourabh Kulkarni et al. published in the esteemed Sicot Journal Published online on 2016 Mar 25. DOI: 10.1051/sicotj/2016008 (PMID: 27163103). The objective of the study was to assess the TTTG distance in 100 MRI scans of skeletally matured Indian knees. The authors defined TT–TG distance by measuring the distance between two parallel vertical lines, one passing through the apex of tibial tuberosity and the other through the apex of the trochlear groove [1]. The technique proposed in the study was based on Wittstein et al. [2] who recorded the TT–TG distance employing an axial image at the level of the insertion of the patellar tendon at the proximal tibial tubercle. But, the study used axial images at the level of the tendon distally for tuberosity reference. Insertion of the patellar tendon in tibia is crescent shaped [3]. Consequently, the measurement of the midpoint of the patellar tendon varies with each slice which in turn might skewer the final TT–TG values. Furthermore, the author uses the center of the patellar tendon as a reference point for tibial tuberosity to obtain the TT–TG distance. This in fact is PT–TG (patellar tendon–trochlear groove) distance which is found to be different from the osseous TT–TG distance. Wilcox et al. [4] in his study revealed the variability in the insertion of the patellar tendon relative to the anterior aspect of the tibial tubercle and concluded that the TT–TG and PT–TG distance were not identical. In the present study the author had essentially used the PT–TG distance (center of the patellar tendon) instead of the anterior most point on the tibial tuberosity and assumed it to be TT–TG distance which might result in varied normal values in the population group. To conclude, the methodology used in the study needs to be verified and the TT–TG distance measured should be ideally referred to as PT–TG distance.

          Related collections

          Most cited references 4

          • Record: found
          • Abstract: found
          • Article: not found

          Magnetic resonance imaging evaluation of patellofemoral malalignment.

          The purpose of this study was to determine the relationship between anterior knee pain secondary to suspected patellofemoral malalignment and tibial tubercle lateralization, patellar tilt, and patellar lateralization on magnetic resonance imaging. We compared the bony relationships of the knee in patients with anterior knee pain and patients with nonspecific internal derangements of the knee. We measured the lateral deviation of the tibial tubercle and the patella from the trochlea, patellar tilt, and patellar and patellar tendon length. The symptomatic knees of patients with anterior knee pain had significantly (P < or = .01) greater lateralization of the tibial tubercle and lateral patellar tilt than did knees of the control group. Patella alta appears to be more common in subjects with anterior knee pain. Magnetic resonance imaging determination of tibial tubercle lateralization and patellar tilt correlates positively with the clinical diagnosis of anterior knee pain, suggesting that patellofemoral pain is caused by subtle malalignment. Level III, development of diagnostic criteria on basis of nonconsecutive patients.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Does landmark selection affect the reliability of tibial tubercle-trochlear groove measurements using MRI?

            A lateralized tibial tubercle is one potential cause of patellar instability. The tibial tubercle-trochlear groove (TT-TG) distance using CT is a reliable measure and considered the gold standard. Using MRI for this purpose has increased, although the reliability of doing so is not well studied.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Patellar instability in Indian population: relevance of tibial tuberosity and trochlear groove distance

              Introduction: The tibial tuberosity to trochlear groove (TTTG) distance in the western population is extensively studied through various modalities such as X-rays, computerised tomography and magnetic resonance imaging. However, to our knowledge there is very little or no literature support to indicate that TTTG distance has been studied in the Indian population. Methods: We therefore undertook a study to measure the TTTG distance in 100 MRI scans of normal Indian knees. Patients with the following co-morbidities were excluded from the study; ligamentous laxity, patellofemoral instability, mal-alignment and osteoarthritis. We measured TTTG distance on the axial MRI slices using OsiriX software. Results: The mean value for females was found to be 14.07 mm and that for male was found to be 13.34 mm. Our study indicates that the TTTG distance, using MRI scans as measurement modality, in the Indian population is significantly different when compared to the published western data. Discussion: We believe that this study can form the basis for future studies on the relationship between TTTG distance and patellar instability in Indian population.
                Bookmark

                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2019
                24 July 2019
                : 5
                : ( publisher-idID: sicotj/2019/01 )
                Affiliations
                [1 ] Fellow in Arthroplasty, Fortis Escorts Hospital Delhi Gurgaon India
                [2 ] Senior Registrar, KEM Hospital 400012 Mumbai India
                Author notes
                [* ]Corresponding author: saigautham90@ 123456gmail.com
                sicotj190013 10.1051/sicotj/2019018
                10.1051/sicotj/2019018
                6656414
                31339845
                © The Authors, published by EDP Sciences, 2019

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Counts
                Figures: 0, Tables: 0, Equations: 0, References: 4, Pages: 1
                Categories
                Knee
                Letter to the Editor

                Comments

                Comment on this article