Editorial Commentary: Measuring Coronal (Mal)Alignment for Patients With Patellar Instability: Tibial Tubercle–to–Trochlear Groove Versus Tibial Tubercle–to–Posterior Cruciate Ligament Distance

Research output: Contribution to journalEditorial

Abstract

Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy. However, measurements of the distance between the tibial tuberosity and the trochlear groove vary substantially according to the imaging modality, knee-flexion angle, and other factors. An alternative approach is to measure the distance between the tibial tuberosity and the posterior cruciate ligament, which negates the confounding influence of the knee-flexion angle. Controversy remains as to the optimum measurement technique. It is crucial that knee surgeons understand the nuances of the technique used to measure coronal alignment so they can choose the optimum surgery to achieve the desired anatomic correction.

Original languageEnglish (US)
Pages (from-to)2035-2037
Number of pages3
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume33
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Ligaments
Knee
Osteotomy
Posterior Cruciate Ligament
Tomography
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

@article{50ce6c76009b4f4d846337e7938b1247,
title = "Editorial Commentary: Measuring Coronal (Mal)Alignment for Patients With Patellar Instability: Tibial Tubercle–to–Trochlear Groove Versus Tibial Tubercle–to–Posterior Cruciate Ligament Distance",
abstract = "Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy. However, measurements of the distance between the tibial tuberosity and the trochlear groove vary substantially according to the imaging modality, knee-flexion angle, and other factors. An alternative approach is to measure the distance between the tibial tuberosity and the posterior cruciate ligament, which negates the confounding influence of the knee-flexion angle. Controversy remains as to the optimum measurement technique. It is crucial that knee surgeons understand the nuances of the technique used to measure coronal alignment so they can choose the optimum surgery to achieve the desired anatomic correction.",
author = "Cosgarea, {Andrew J}",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.arthro.2017.09.002",
language = "English (US)",
volume = "33",
pages = "2035--2037",
journal = "Arthroscopy - Journal of Arthroscopic and Related Surgery",
issn = "0749-8063",
publisher = "W.B. Saunders Ltd",
number = "11",

}

TY - JOUR

T1 - Editorial Commentary

T2 - Measuring Coronal (Mal)Alignment for Patients With Patellar Instability: Tibial Tubercle–to–Trochlear Groove Versus Tibial Tubercle–to–Posterior Cruciate Ligament Distance

AU - Cosgarea, Andrew J

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy. However, measurements of the distance between the tibial tuberosity and the trochlear groove vary substantially according to the imaging modality, knee-flexion angle, and other factors. An alternative approach is to measure the distance between the tibial tuberosity and the posterior cruciate ligament, which negates the confounding influence of the knee-flexion angle. Controversy remains as to the optimum measurement technique. It is crucial that knee surgeons understand the nuances of the technique used to measure coronal alignment so they can choose the optimum surgery to achieve the desired anatomic correction.

AB - Excessive lateralization of the tibial tuberosity is one of the anatomic factors that contribute to lateral patellar instability, which we usually correct surgically with tibial tuberosity osteotomy. Traditionally, coronal alignment was determined clinically by measuring the Q angle, which has proven to be unreliable. Radiographic measurements of coronal alignment made using computed tomography and magnetic resonance imaging are more reliable and have become the standard for determining the need for corrective tibial tuberosity osteotomy. However, measurements of the distance between the tibial tuberosity and the trochlear groove vary substantially according to the imaging modality, knee-flexion angle, and other factors. An alternative approach is to measure the distance between the tibial tuberosity and the posterior cruciate ligament, which negates the confounding influence of the knee-flexion angle. Controversy remains as to the optimum measurement technique. It is crucial that knee surgeons understand the nuances of the technique used to measure coronal alignment so they can choose the optimum surgery to achieve the desired anatomic correction.

UR - http://www.scopus.com/inward/record.url?scp=85032817668&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032817668&partnerID=8YFLogxK

U2 - 10.1016/j.arthro.2017.09.002

DO - 10.1016/j.arthro.2017.09.002

M3 - Editorial

C2 - 29102017

AN - SCOPUS:85032817668

VL - 33

SP - 2035

EP - 2037

JO - Arthroscopy - Journal of Arthroscopic and Related Surgery

JF - Arthroscopy - Journal of Arthroscopic and Related Surgery

SN - 0749-8063

IS - 11

ER -