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Purpose <p>To evaluate the relationship between TT–TG distance and lower-limb anatomical parameters in recurrent patellar dislocation.</p> Methods <p>Weight-bearing long-leg radiographs and knee CT scans of 99 patients with recurrent patellar dislocation were reviewed. Trochlear dysplasia was classified according to the Dejour version 2 classification. Tibial tubercle–trochlear groove (TT–TG) distance was measured together with coronal alignment (mFTA and related angles) and rotational alignment (tibiofemoral rotation and tibial torsion). Patients were stratified by TT–TG distance and mFTA-based alignment. Pearson correlations examined associations among anatomical parameters. In the TT–TG ≥ 20&#xa0;mm group, multivariable regression explored factors potentially associated with TT–TG distance.</p> Results <p>Most patients had trochlear dysplasia, and a high proportion were classified as Dejour type C or D (71/99, 71.7%). Overall, TT–TG distance was significantly positively correlated with TFR (<i>r</i> = 0.504, <i>P</i> &lt; 0.001). TFR was significantly higher in the TT–TG ≥ 20&#xa0;mm group than in the TT–TG &lt; 20&#xa0;mm group (11.05° ± 4.06° vs. 6.68° ± 4.85°, <i>P</i> &lt; 0.001). In the TT–TG &lt; 20&#xa0;mm group, TT–TG distance was positively correlated with TFR (<i>r</i> = 0.422, <i>P</i> = 0.003) and tibial torsion (TT) (<i>r</i> = 0.320, <i>P</i> = 0.027). In contrast, in the TT–TG ≥ 20&#xa0;mm group, TT–TG showed no significant correlations with the assessed anatomical parameters; however, TFR was negatively correlated with TGM (<i>r</i> = − 0.328, <i>P</i> = 0.019). Stratified analysis showed significant correlations between TFR and TT–TG distance in valgus (<i>r</i> = 0.676, <i>P</i> = 0.003) and neutral (<i>r</i> = 0.441, <i>P</i> &lt; 0.001) alignment groups, but not in the varus group.</p> Conclusion <p>In patients with recurrent patellar dislocation, TT–TG distance was positively associated with tibiofemoral rotation but not with coronal lower-limb alignment. This association was more evident in patients with TT–TG &lt; 20&#xa0;mm and was attenuated in those with TT–TG ≥ 20&#xa0;mm. These findings suggest that TT–TG distance should be interpreted together with rotational alignment and trochlear morphology when planning individualized treatment.</p>

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Associations between TT–TG distance and rotational and coronal alignment in recurrent patellar dislocation

  • 期刊论文

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  • 发表日期：

    2026年6月22日

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  • Liang Ma,
  • Qingyu Li,
  • Jiacheng Wei,
  • Shaoyu Zhi,
  • Zhicheng Xia,
  • Haonan Wang,
  • Lei Liu,
  • Chenxia Shi,
  • Xiaofeng Wang

摘要

Purpose

To evaluate the relationship between TT–TG distance and lower-limb anatomical parameters in recurrent patellar dislocation.

Methods

Weight-bearing long-leg radiographs and knee CT scans of 99 patients with recurrent patellar dislocation were reviewed. Trochlear dysplasia was classified according to the Dejour version 2 classification. Tibial tubercle–trochlear groove (TT–TG) distance was measured together with coronal alignment (mFTA and related angles) and rotational alignment (tibiofemoral rotation and tibial torsion). Patients were stratified by TT–TG distance and mFTA-based alignment. Pearson correlations examined associations among anatomical parameters. In the TT–TG ≥ 20 mm group, multivariable regression explored factors potentially associated with TT–TG distance.

Results

Most patients had trochlear dysplasia, and a high proportion were classified as Dejour type C or D (71/99, 71.7%). Overall, TT–TG distance was significantly positively correlated with TFR (r = 0.504, P < 0.001). TFR was significantly higher in the TT–TG ≥ 20 mm group than in the TT–TG < 20 mm group (11.05° ± 4.06° vs. 6.68° ± 4.85°, P < 0.001). In the TT–TG < 20 mm group, TT–TG distance was positively correlated with TFR (r = 0.422, P = 0.003) and tibial torsion (TT) (r = 0.320, P = 0.027). In contrast, in the TT–TG ≥ 20 mm group, TT–TG showed no significant correlations with the assessed anatomical parameters; however, TFR was negatively correlated with TGM (r = − 0.328, P = 0.019). Stratified analysis showed significant correlations between TFR and TT–TG distance in valgus (r = 0.676, P = 0.003) and neutral (r = 0.441, P < 0.001) alignment groups, but not in the varus group.

Conclusion

In patients with recurrent patellar dislocation, TT–TG distance was positively associated with tibiofemoral rotation but not with coronal lower-limb alignment. This association was more evident in patients with TT–TG < 20 mm and was attenuated in those with TT–TG ≥ 20 mm. These findings suggest that TT–TG distance should be interpreted together with rotational alignment and trochlear morphology when planning individualized treatment.