{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:37:41Z","timestamp":1793263061348,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify magnetic resonance imaging (MRI)\u2010based thresholds for measurements of malalignment and assess their ability to identify knees with patellar instability, while evaluating the impact of patient sex and height on these thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted to identify patients with symptomatic patellar instability and compare them with age\u2010 and sex\u2010 matched controls, defined as patients with meniscus tears without patellofemoral pathology. Tibial tuberosity to trochlear groove (TTTG) and tibial tuberosity\u2010posterior cruciate ligament (TT\u2010PCL) distances were measured on axial knee MRI. Receiver operating characteristic curves were calculated, and an area under the curve greater than 0.7 was considered a good diagnostic test. Youden's J statistic was used to establish diagnostic thresholds. Subgroup analysis was performed based on sex and height.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 240 patients (64% female; age: 27\u2009\u00b1\u20099\u2009years). Area under the curve was 0.75 (0.69, 0.81) for TTTG distance, but below 0.7 for TT\u2010PCL distance. Cutoff values for TTTG distance identifying patellar instability were 13.7 mm and 14.7\u2009mm in female patients &lt; and &gt;=\u2009165.1\u2009cm, respectively. In male patients, cutoff values were 16.1 mm and 20.1\u2009mm for male patients &lt; and &gt;=\u2009177.8 cm, respectively. TTTG distance had good diagnostic accuracy in both female patients (0.78 (0.7, 0.85)) and male patients (0.7 (0.57, 0.82)), with greater predictive ability in male patients below (0.79 (0.61, 0.94)) versus above (0.56 (0.39, 0.72)) the median height and similar efficacy among female patients below (0.76 (0.64, 0.86)) and above (0.77 (0.64, 0.88)) the median height.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TTTG distance measurements on MRI showed that threshold values for patellar instability were 16.1 mm vs 20.1\u2009mm in male patients below and above the median height, and in female patients were 13.7\u2009mm vs 14.7 mm for those below and above the median height, respectively. These differences highlight a need for incorporating patient\u2010specific factors when using these thresholds in clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective comparative case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70428","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:55:47Z","timestamp":1785304547000},"page":"2674-2681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex and Height Impact Tibial Tuberosity to Trochlear Groove Distance Thresholds for Malalignment on Magnetic Resonance Imaging When Comparing Knees With Patellar Instability Versus Age\u2010 and Sex\u2010Matched Controls"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7675-603X","authenticated-orcid":false,"given":"Varun","family":"Nukala","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isha Tushar","family":"Wadhavkar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharsini","family":"Rangaswamy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Velasquez\u2010Hammerle","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1039-3314","authenticated-orcid":false,"given":"Kartik Mangudi","family":"Varadrajan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6489-3803","authenticated-orcid":false,"given":"Miho Jean","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000674"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01552649"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511404883"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519888467"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967121993179"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515597906"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659001800508"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513507423"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221138287"},{"key":"e_1_2_8_12_1","first-page":"423","article-title":"The measurement of the tibial tuberosity. 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