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- W2944926894 abstract "Abstract Background Tibial tubercle-trochlear groove (TT-TG) distance is a measurement generally made on CT scans that is commonly used to quantify the risk of patellofemoral instability (PFI); however, its interrater reliability and accuracy as an indicator of PFI in patients is poorly characterized. Questions/purposes The purposes of our study were (1) to primarily analyze interrater reliability of the TT-TG distance among orthopaedists with varied experience as measured by MRI, (2) to secondarily compare TT-TG distances between PFI and control groups, and (3) to determine an accurate TT-TG distance threshold indicative of PFI. Methods The electronic medical records of a senior fellowship-trained orthopaedic sports medicine surgeon were surveyed between 2012 and 2016 for patients who had experienced at least one episode of patellar subluxation or dislocation, who reported no other knee-related history, and who underwent MRI due to persistent PFI signs and symptoms. The records of 48 PFI patients (23 males, 25 females; 19 ± 4 years of age) were compared with 83 controls (60 males, 23 females; 31 ± 8 years of age) having no history of PFI, presenting with an isolated meniscal lesion as determined from MRI and treated by the same orthopaedist during this time. All records meeting study criteria were consecutively included to offset selection bias of the retrospective analysis. Two sports medicine fellows, one who had just completed orthopaedic residency training, and another with a year of experience after residency, and a sports medicine subspecialist with more than 15 years of experience in practice independently recorded TT-TG distance, indicative of tibial tubercle lateralization relative to the femoral trochlea, to the nearest millimeter (mm) in a blinded and randomized fashion. Intraclass correlation coefficient computed interrater reliability accompanied by standard error of measurement (SEM); a one-tailed, two-sample t-test analyzed group differences with accompanying effect size per Cohen’s d; receiver operating characteristic (ROC) curve determined accuracy and threshold for PFI risk. A p value < 0.05 denoted statistical significance. Results Interrater reliability was excellent, at 0.93 (95% confidence interval [CI], 0.84–0.97; SEM = 0.6 mm) for PFI patients and 0.95 (95% CI, 0.91–0.97; SEM = 0.4 mm) for controls. Distance was greater (95% CI, 2–5; p < 0.001) in PFI patients (14 ± 4 mm; range = 7–24 mm) than controls (10 ± 3 mm; range = 3–19 mm) with an effect size of 1 (95% CI, 0.3–2). Area under the ROC curve was 0.75 (95% CI, 0.66–0.83) and threshold was 13 mm (sensitivity = 0.52, 1-specificity = 0.25), suggesting the measure is a fairly accurate indicator of risk and values of 13 mm or greater are better suited to rule in PFI. Respective positive and negative likelihood ratios of 2 and 0.6 at this threshold confirm that this distance yields a small increase in probability for PFI and a minimal decrease in probability for risk; specifically, a 13-mm TT-TG distance is two times more likely to be found in patients with PFI. Furthermore, this threshold is estimated to increase a correct PFI diagnosis by approximately 15%. Conclusions The MRI-specific TT-TG distance, based on a single measurement using cartilaginous-tendon landmarks within a standardized trochlear range, is reliable as performed by orthopaedists of varied experience. Patients with PFI display a 4-mm greater distance than controls, which may represent a difference large enough for clinicians to discern in practice using MRI. A 13-mm TT-TG distance is two times more likely seen in patients with PFI. However, this threshold increases a correct PFI diagnosis by only about 15%; therefore, clinical decision-making should not be influenced by this criterion alone and instead used in conjunction with other relevant variables. Level of Evidence Level IV, diagnostic study," @default.
- W2944926894 created "2019-05-29" @default.
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- W2944926894 date "2019-05-15" @default.
- W2944926894 modified "2023-10-17" @default.
- W2944926894 title "Tibial Tubercle-Trochlear Groove Distance Is a Reliable and Accurate Indicator of Patellofemoral Instability" @default.
- W2944926894 cites W108582297 @default.
- W2944926894 cites W1424235632 @default.
- W2944926894 cites W1597817566 @default.
- W2944926894 cites W1830758076 @default.
- W2944926894 cites W1965523766 @default.
- W2944926894 cites W1967797264 @default.
- W2944926894 cites W1978218100 @default.
- W2944926894 cites W1979617691 @default.
- W2944926894 cites W1980276147 @default.
- W2944926894 cites W1980721081 @default.
- W2944926894 cites W1981905832 @default.
- W2944926894 cites W1993270862 @default.
- W2944926894 cites W2004609458 @default.
- W2944926894 cites W2011808739 @default.
- W2944926894 cites W2012219103 @default.
- W2944926894 cites W2017291372 @default.
- W2944926894 cites W2017460912 @default.
- W2944926894 cites W2019273574 @default.
- W2944926894 cites W2023284917 @default.
- W2944926894 cites W2029426756 @default.
- W2944926894 cites W2039305503 @default.
- W2944926894 cites W2041445892 @default.
- W2944926894 cites W2048401668 @default.
- W2944926894 cites W2054619190 @default.
- W2944926894 cites W2055269621 @default.
- W2944926894 cites W2058898046 @default.
- W2944926894 cites W2060708003 @default.
- W2944926894 cites W2075031055 @default.
- W2944926894 cites W2075763977 @default.
- W2944926894 cites W2079801114 @default.
- W2944926894 cites W2080149582 @default.
- W2944926894 cites W2083786566 @default.
- W2944926894 cites W2084629298 @default.
- W2944926894 cites W2086781093 @default.
- W2944926894 cites W2091793899 @default.
- W2944926894 cites W2092716988 @default.
- W2944926894 cites W2092977504 @default.
- W2944926894 cites W2093680557 @default.
- W2944926894 cites W2096692218 @default.
- W2944926894 cites W2101015418 @default.
- W2944926894 cites W2105991223 @default.
- W2944926894 cites W2106083240 @default.
- W2944926894 cites W2107026277 @default.
- W2944926894 cites W2108198972 @default.
- W2944926894 cites W2117352205 @default.
- W2944926894 cites W2121774522 @default.
- W2944926894 cites W2123903646 @default.
- W2944926894 cites W2130852648 @default.
- W2944926894 cites W2138176067 @default.
- W2944926894 cites W2141936559 @default.
- W2944926894 cites W2145345314 @default.
- W2944926894 cites W2151287133 @default.
- W2944926894 cites W2151811607 @default.
- W2944926894 cites W2152169070 @default.
- W2944926894 cites W2156762605 @default.
- W2944926894 cites W2157430869 @default.
- W2944926894 cites W2157825442 @default.
- W2944926894 cites W2171734077 @default.
- W2944926894 cites W2179333072 @default.
- W2944926894 cites W2182716049 @default.
- W2944926894 cites W2195480220 @default.
- W2944926894 cites W2196108255 @default.
- W2944926894 cites W2201764323 @default.
- W2944926894 cites W2327037637 @default.
- W2944926894 cites W2331972595 @default.
- W2944926894 cites W2339877350 @default.
- W2944926894 cites W2396478570 @default.
- W2944926894 cites W2400682781 @default.
- W2944926894 cites W2512471861 @default.
- W2944926894 cites W2547157569 @default.
- W2944926894 cites W2557343783 @default.
- W2944926894 cites W2592424226 @default.
- W2944926894 cites W2606450195 @default.
- W2944926894 cites W2611305499 @default.
- W2944926894 cites W2614691561 @default.
- W2944926894 cites W2617595617 @default.
- W2944926894 cites W26395845 @default.
- W2944926894 cites W2676736376 @default.
- W2944926894 cites W2750469190 @default.
- W2944926894 cites W2753252997 @default.
- W2944926894 cites W2763422756 @default.
- W2944926894 cites W2765740629 @default.
- W2944926894 cites W2886279679 @default.
- W2944926894 cites W4235861022 @default.
- W2944926894 cites W4236135856 @default.
- W2944926894 doi "https://doi.org/10.1097/corr.0000000000000711" @default.
- W2944926894 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6554121" @default.
- W2944926894 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/31094842" @default.