{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:19:59Z","timestamp":1792498799126,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T00:00:00Z","timestamp":1669075200000},"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":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tibial tubercle\u2013trochlear groove (TT-TG) distance is a risk factor for recurrent patellar dislocation and is often included in algorithmic treatment of instability. The underlying factors that determine TT-TG have yet to be clearly described in orthopaedic literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypothesis:<\/jats:title>\n                    <jats:p>The purpose of our study was to determine the underlying anatomic factors contributing to TT-TG distance. We hypothesized that degree of tubercle lateralization and knee rotation angle may substantially predict TT-TG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional study; Level of evidence, 3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients evaluated for patellar instability at a single institution between 2013 and 2021 were included. Patients with previous knee osseous procedures were excluded. TT-TG and its anatomic relationship to patellofemoral measures, including dysplasia, femoral anteversion, tibial tubercle lateralization, knee rotation angle, and tibial torsion, were measured and subsequently quantified using univariate and multivariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, 76 patients met the inclusion criteria (46 female, 30 male; mean \u00b1 SD age, 20.6 \u00b1 8.6 years) and were evaluated. Mean TT-TG was 16.2 \u00b1 5.4 mm. On univariate analysis, increasing knee rotation angle ( P &lt; .01), tibial tubercle lateralization ( P = .02), and tibial torsion ( P = .01) were associated with increased TT-TG. In dysplastic cases, patients without medial hypoplasia (Dejour A or B) demonstrated significantly increased TT-TG (18.1 \u00b1 5.4 mm) as compared with those with medial hypoplasia (Dejour C or D; TT-TG: 14.9 \u00b1 5.2 mm; P = .02). Multivariable analysis revealed that increased knee rotation angle (+0.43-mm TT-TG per degree; P &lt; .01) and tubercle lateralization (+0.19-mm TT-TG per percentage lateralization; P &lt; .01) were statistically significant determinants of increased TT-TG distance. Upon accounting for these factors, tibial torsion, trochlear width, and medial hypoplasia were no longer significant components in predicting TT-TG ( P\u2265 .54). Of note, all patients with TT-TG \u226520 mm had tibial tubercle lateralization \u226568%, a knee rotation angle \u22655.8\u00b0, or both factors concurrently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>TT-TG distance is most influenced by knee rotation angle and tibial tubercle lateralization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465221136535","type":"journal-article","created":{"date-parts":[[2022,11,22]],"date-time":"2022-11-22T07:33:06Z","timestamp":1669102386000},"page":"25-31","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Factors That Affect the Magnitude of Tibial Tubercle\u2013Trochlear Groove Distance in Patients With Patellar Instability"],"prefix":"10.1177","volume":"51","author":[{"given":"Mario","family":"Hevesi","sequence":"first","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"},{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navya","family":"Dandu","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Credille","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Wang","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athan G.","family":"Zavras","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Cregar","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A.","family":"Trasolini","sequence":"additional","affiliation":[{"name":"School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam B.","family":"Yanke","sequence":"additional","affiliation":[{"name":"Midwest Orthopaedics at Rush, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,11,22]]},"reference":[{"key":"bibr1-03635465221136535","first-page":"199","volume-title":"Selected Papers of Hirotugu Akaike","volume":"1998","author":"Akaike 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