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Computerized Tomographic Analysis of Tibial Tubercle Position in the Painful Female Patellofemoral Joint

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Haruyasy Yamamoto, MD

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Toshiro Ishibashi, MD

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Shintaro Asahina, MD

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Kohtaro Furuya, MD

Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan

We used computerized tomography to evaluate the po sition of the tibial tubercle and to determine if the tibial tubercle is positioned more laterally in female patients with patellofemoral pain. We also wanted to determine the relationship of the tibial tubercle to tibial external rotation and patellar tilt. Sixty female patients and 19 healthy female controls were evaluated. To evaluate the position of the tibial tubercle, the tibial tubercle rotation angle (the angle formed by the line between the pos teriormost edges of the medial and lateral femoral con dyle and the line between the central point of the in tercondylar space and the central point of the patellar tendon at the level of the tibial tubercle) was measured by superimposing the images from the level of the distal femoral condyle and the tibial tubercle. The relationship between the tibial tubercle rotation angle and patellar tilt was then assessed by dividing the patients into 3 sub groups according to the patellar tilt. The tibial tubercle rotation angle was significantly different between the patellofemoral pain patients and the controls. There were also significant differences between the patients with moderate patellar tilt (10° to 20°) and the controls, and between the patients with high patellar tilt (>20°) and the controls.

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