Effects of knee flexion and extension on the tibial tuberosity–trochlear groove (TT–TG) distance in adolescents

Background Measurement of the tibial tubercle–trochlear groove (TT–TG) distance is used to assess patellofemoral instability and rotation. Since patellofemoral instability and acute patellar dislocation are common among adolescents, it is important to clarify the relationship between TT–TG distance and various flexion and extension angles in asymptomatic children. The purpose of the present study was to determine how knee flexion and extension influence TT–TG-distance values measured using 3D imaging in an anatomic axial plane among asymptomatic adolescents. Methods We performed magnetic resonance imaging (MRI) of 26 knees in 13 adolescents (8 boys and 5 girls) of 11–17 years of age, with no known patellofemoral disorders. Imaging was performed with 3.0 T MRI with the knee at four separate angles of flexion between 0° and 30°. Measurements were made by two independent blinded raters. Results The mean TT–TG distance in millimetres was 11.1–0.29 × the angle in degrees. TT–TG distance decreased with greater flexion, showing a mean decrease of 0.29 mm (SD, 0.04) per degree of increased flexion ( p