Factors Affecting Tibial Tuberosity-Trochlear Groove Distance in Recurrent Patellar Dislocation (original) (raw)

2018, Clinics in Orthopedic Surgery

Recurrent patellar dislocation is a result of aberration of normal patellofemoral kinematics. 1,2) The anatomical deterrent resulting in malalignment of the knee may be multifactorial. 3,4) Problems in both static and dynamic stabilizers of the knee joint may have a role, and therefore it is difficult to find a single treatment protocol that would be applicable for all patients uniformly. 5,6) The fact that over 100 procedures have been described for the management of this condition stresses the fact that no single procedure works in all cases. 1-3,5,6) Depending on the etiology, both proximal and dis-tal realignment procedures have been described for the treatment of recurrent patellar dislocation. Proximal realignment using lateral release and medial patellofemoral ligament reconstruction has demonstrated good results. 6,7) However, the indications and results of distal realignment using tuberosity transfer have been controversial. 8-11) Goutallier et al. 12) described the tibial tuberosity-trochlear groove (TT-TG) distance as a quantitative measure of lateralization of the tibial tuberosity on the proximal tibia. Dejour et al. 13) concluded 20 mm as a cutoff for tuberosity transfer. However, the literature has not always shown favorable results of tuberosity transfer, and thus we sought to investigate whether the TT-TG alone is an appropriate criterion to determine the transfer of tibial tuberosity. Since it is important to identify the root cause of malalignment and address the contributing factors, 14) tuberosity transfer would be of aid for patients who have severe tuberosity lateralization. 15) However, the TT-TG dis

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