{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T19:03:42Z","timestamp":1791745422736,"version":"4.3.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T00:00:00Z","timestamp":1442880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with patellar instability and a tibial tubercle\u2013trochlear groove (TT-TG) distance \u226520 mm may be candidates for distal tubercle realignment surgery. Although this variable has proven valuable in predicting recurrent dislocations, it is not individualized to patient size, bony structure, or patellofemoral mechanics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To develop a patellar instability ratio (PIR) that predicts the risk of recurrent instability based on the TT-TG distance to patient-specific anatomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>On magnetic resonance imaging scans of 59 knees with patellar instability, the TT-TG distance, tibial tubercle\u2013posterior cruciate ligament (TT-PCL) distance, sagittal patellar length (PL), sagittal trochlear length (TL), axial patellar width (PW), and axial trochlear width (TW) were calculated by 2 observers in a blinded and randomized fashion. Patients were divided into 2 groups: those with a single dislocation and those with multiple (\u22652) dislocations. The ability of the TT-TG and TT-PCL distances as well as the 8 different ratios to predict recurrent instability was assessed by calculating odds ratios (ORs), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each measure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twelve knees (20%) experienced a single dislocation, while 47 (80%) sustained multiple dislocations. A TT-TG distance \u226520 mm was predictive of recurrent instability, with a sensitivity, specificity, and PPV of 21%, 100%, and 100%, respectively. The OR for TT-TG \u226520 mm was 5.38 ( P = .29), while the highest ORs for recurrent instability were noted for a TT-TG\/PW \u22650.4 (OR, 7.37; P = .02) and a TT-TG\/TW \u22650.5 (OR, 8.88; P = .04). The sensitivity, specificity, and PPV of a TT-TG\/PW \u22650.4 were 62%, 83%, and 94%, respectively, while those of a TT-TG\/TW \u22650.5 were 45%, 92%, and 95%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Two novel PIRs (TT-TG\/TW and TT-TG\/PW) were identified and found to more effectively predict recurrent instability than the TT-TG distance alone. Each ratio takes into account patient-specific anatomy and can be measured in an accurate and reliable fashion by clinicians. These PIRs are a step toward overcoming some of the limitations of using the TT-TG distance in isolation. Further investigation into the clinical applications and utility of the TT-TG\/TW is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546515602483","type":"journal-article","created":{"date-parts":[[2015,9,22]],"date-time":"2015-09-22T23:00:47Z","timestamp":1442962847000},"page":"393-399","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":77,"title":["Individualizing the Tibial Tubercle\u2013Trochlear Groove Distance"],"prefix":"10.1177","volume":"44","author":[{"given":"Christopher L.","family":"Camp","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Heidenreich","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane L.","family":"Dahm","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron J.","family":"Krych","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine Center, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,9,22]]},"reference":[{"key":"bibr1-0363546515602483","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511404883"},{"key":"bibr2-0363546515602483","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.59B2.873986"},{"key":"bibr3-0363546515602483","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3405-7"},{"issue":"5","key":"bibr4-0363546515602483","first-page":"317","volume":"68","author":"Caton J","year":"1982","journal-title":"Rev Chir Orthop Reparatrice Appar 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