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The authors adhered to the PRISMA and R\u2010AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on inter\u2010rater and intra\u2010rater reliability, receiver\u2010operating characteristic (ROC) curve parameters such as area under the curve (AUC), sensitivity and specificity, as well as odds ratios, cutoff values for pathological diagnosis and correlations between TT\u2013TG and TT\u2013PCL were recorded. The MINORS score was used for all studies in order to perform a quality assessment of included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 23 studies comprising 2839 patients (2922\u00a0knees) were included in this review. Inter\u2010rater reliability ranged from 0.71 to 0.98 and 0.55 to 0.99 for TT\u2013TG and TT\u2013PCL, respectively. Intra\u2010rater reliability ranged from 0.74 to 0.99 and 0.88 to 0.98 for TT\u2013TG and TT\u2013PCL, respectively. AUC measuring diagnostic accuracy of patellar instability for TT\u2013TG ranged from 0.80 to 0.84 and 0.58 to 0.76 for TT\u2013PCL. Five studies found TT\u2013TG to have more discriminatory power than TT\u2013PCL at distinguishing patients with patellar instability from patients who do not. Sensitivity and specificity ranged from 21 to 85% and 62 to 100%, respectively, for TT\u2013TG. Sensitivity and specificity ranged from 30 to 76% and 46 to 86%, respectively, for TT\u2013PCL. Odds ratio values ranged from 1.06 to 14.02 for TT\u2013TG and 0.98 to 6.47 for TT\u2013PCL. Proposed cutoff TT\u2013TG and TT\u2013PCL values for predicting patellar instability ranged from 15.0 to 21.4\u00a0mm and 19.8 to 28.0\u00a0mm, respectively. Eight studies reported significant positive correlations between TT\u2013TG and TT\u2013PCL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TT\u2013TG resulted in overall similar reliability, sensitivity and specificity as TT\u2013PCL; however, TT\u2013TG has better diagnostic accuracy than TT\u2013PCL in the context of patellar instability as per AUC and odds ratio values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level IV.<\/jats:p>\n                  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