Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 22, Issue 11, pp 2655–2661 | Cite as

Influence of knee flexion angle and weight bearing on the Tibial Tuberosity-Trochlear Groove (TTTG) distance for evaluation of patellofemoral alignment

  • Kaywan IzadpanahEmail author
  • Elisabeth Weitzel
  • Marco Vicari
  • Jürgen Hennig
  • Matthias Weigel
  • Norbert P. Südkamp
  • Philipp Niemeyer



The aim of the present study was to investigate the influence of knee flexion and weight bearing on the Tibial Tuberosity-Trochlear Groove (TTTG) distance.

Materials and methods

Magnetic resonance imaging of the knee was carried out in 8 healthy volunteers. An open 0.25 T scanner equipped with a C-shaped permanent tilting magnet allowing examinations in weight-bearing conditions was used for the present investigation. A 3D gradient-echo sequence with axial slice orientation was obtained in a lying and an upright position with the knee straight and at 30° of knee flexion. The medial, central and lateral trochlear heights as well as the TTTG were determined.


The mean medial trochlear height was 76.2 ± 4 %, the central trochlear height was 72.2 ± 3 %, and lateral trochlear height was 82.9 ± 3 %. The mean TTTG distance was 11.6 ± 4.4 mm in lying position at 0° knee flexion and 7.3 ± 2.9 mm (n.s.) at 30° knee flexion. Under weight bearing, the mean TTTG was significantly smaller at both 0° knee flexion 6.3 ± 3.2 mm (p = 0.040) and 30° knee flexion 4.9 ± 3.9 mm (p = 0.006) compared to the lying position with 0° knee flexion.


Tibial Tuberosity-Trochlear Groove distance depends on both knee flexion angle and weight bearing. The latter only seems to be of relevance in full extension.


Tibial Tuberosity-Trochlear Groove MRI Weight bearing Knee flexion Quadriceps muscle activation 


Conflict of interest

The authors report the following potential conflict of interest or source of funding in relation to this article: M. Vicari is an employee of and J. Hennig is a consultant for Esaote S.p.A., Genoa, Italy.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Kaywan Izadpanah
    • 1
    Email author
  • Elisabeth Weitzel
    • 1
  • Marco Vicari
    • 2
    • 3
  • Jürgen Hennig
    • 3
  • Matthias Weigel
    • 3
  • Norbert P. Südkamp
    • 1
  • Philipp Niemeyer
    • 1
  1. 1.Department of Orthopedic and Trauma SurgeryUniversity Medical Center FreiburgFreiburgGermany
  2. 2.Esaote SpAGenoaItaly
  3. 3.Department of Radiology, Medical PhysicsUniversity Medical CenterFreiburgGermany

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