{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T18:51:10Z","timestamp":1773600670844,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>It is unclear if an elevated tibial tubercle\u2013trochlear groove (TT\u2013TG) distance is a risk factor for poor outcomes following ACLR. Therefore, the purpose of this study was to determine whether patients with an elevated TT\u2013TG have an increased risk of retear following primary ACLR compared to controls with a normal TT\u2013TG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent primary ACLR between July 2018 and June 2019 with an available preoperative magnetic resonance imaging (MRI) were eligible for inclusion. TT\u2013TG distance was measured on preoperative MRI scans by two independent investigators. Clinical outcomes, return\u2010to\u2010sport rates, and Lysholm scores were compared between patients with a TT\u2013TG\u2009&lt;\u200912.5\u00a0mm (normal) and those with a TT\u2013TG\u2009\u2265\u200912.5\u00a0mm (elevated).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 159 patients were included, 98 with normal TT\u2013TG distance and 61 with elevated TT\u2013TG distance. Patients with an elevated TT\u2013TG distance had worse post\u2010operative Lysholm scores than patients with a normal TT\u2013TG distance (83.0 vs. 95.0, <jats:italic>p<\/jats:italic>\u2009=\u20090.010). In patients who received a bone\u2013patellar tendon\u2013bone (BTB) graft, an elevated TT\u2013TG distance was associated with higher rates of subjective instability (13.0% vs. 3.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.041), reoperation (13.0% vs. 1.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.012), and post\u2010operative complications (25.0% vs. 8.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.026), as well as lower ACL psychological readiness scores (324.1 vs. 446.7, <jats:italic>p<\/jats:italic>\u2009=\u20090.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with an elevated pre\u2010operative TT\u2013TG distance have worse Lysholm scores than patients with normal TT\u2013TG distance. Patients with an elevated pre\u2010operative TT\u2013TG distance who underwent ACLR with BTB grafts had significantly higher rates of subjective instability, reoperation, and post\u2010operative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07191-0","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T13:03:08Z","timestamp":1665579788000},"page":"2446-2453","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of post\u2010operative outcomes following anterior cruciate ligament reconstruction between patients with vs. without elevated tibial tubercle\u2013trochlear groove (TT\u2013TG) distance"],"prefix":"10.1002","volume":"31","author":[{"given":"Ryan W.","family":"Paul","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Rothman Orthopaedic Institute Philadelphia PA US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rothman Orthopaedic Institute Philadelphia PA US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anya","family":"Hall","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Rothman Orthopaedic Institute Egg Harbor Township NJ US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ari","family":"Clements","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Sidney Kimmel Medical College Philadelphia PA US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan E.","family":"Bishop","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Rothman Orthopaedic Institute 645 Madison Avenue 3rd and 4th floors 10022 New York NY US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael G.","family":"Ciccotti","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rothman Orthopaedic Institute Philadelphia PA US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Rothman Orthopaedic Institute Philadelphia PA US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3238-7839","authenticated-orcid":false,"given":"Brandon J.","family":"Erickson","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Rothman Orthopaedic Institute 645 Madison Avenue 3rd and 4th floors 10022 New York NY US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330143"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/19417381211056873"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.14799"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.11.030"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120973665"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120964919"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546521999109"},{"key":"e_1_2_9_9_2","first-page":"279","article-title":"Conservative versus surgical treatment for primary patellar dislocation","volume":"117","author":"Frings J","year":"2020","journal-title":"Dtsch \u00c4rztebl 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Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07191-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-022-07191-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07191-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-022-07191-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:10:43Z","timestamp":1760883043000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-022-07191-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,12]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1007\/s00167-022-07191-0"],"URL":"https:\/\/doi.org\/10.1007\/s00167-022-07191-0","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,12]]},"assertion":[{"value":"21 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ryan Paul: none. Emma Johnson: none. Anya Hall: none. Ari Clements: none. Meghan Bishop: education fees and grant funding from Arthrex Inc. Hospitality fees from Stryker Corporation. Education fees from Smith & Nephew Inc. Education fees from Gotham Surgical Solutions & Devices, Inc. Michael Ciccotti: American Orthopaedic Society for Sports Medicine: board or committee member. Major League Baseball Team Physicians Association: board or committee member. Orthopaedic Learning Center: board or committee member. Steven Cohen: American Orthopaedic Society for Sports Medicine: board or committee member. International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine: board or committee member. Arthrex, Inc: research support. Major League Baseball: research support. CONMED Linvatec: paid consultant. Slack, INC: publishing royalties, financial or material support. Zimmer: IP royalties; paid consultant; paid presenter or speaker. Brandon Erickson: AAOS: board or committee member. American Orthopaedic Society for Sports Medicine: board or committee member. American Shoulder and Elbow Surgeons: board or committee member. PLOS One: editorial or governing board. Arthrex, Inc: paid consultant; research support. DePuy, A Johnson & Johnson Company: research support. Linvatec: research support. Smith & Nephew: research support. Stryker: research support.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the institutional review board (Thomas Jefferson University #21E.511).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}