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The tibial tubercle–trochlear groove distance: a comparison study between EOS and MRI in the paediatric population

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Abstract

Objective

This study aims to compare the relative reliability and accuracy of TT-TG measurements in EOS with that of MRI in a paediatric population.

Methods

Patients were included if they underwent both an MRI and EOS scans and were under the age of 16. Two authors recorded the TT-TG distances on each modality at two separate time points. In the EOS images, the distance between the two points was measured in the horizontal 2D plane. In the MRI images, it was done in the plane referenced by posterior femoral condylar axis. The intra- and inter-rater reliability was assessed in each modality and between modalities.

Results

Twenty-seven patients (30 knees), 14 males, and 13 females with an average age of 13 years (range: 7–16 years) were included in the study. The mean TT-TG distance on EOS scan and MRI scan was 14 mm. On inter- and intra-observer analysis, both imaging modalities had excellent reliability (0.97 ICC for EOS and 0.98 ICC for MRI inter-observer) and repeatability (0.98–0.99 ICC for EOS and 0.99 ICC for MRI for intra-observer). However, on comparing the two imaging modalities (EOS vs MRI), the ICC was fair (0.56 ICC for rater 1 and 0.65 ICC for rater 2).

Conclusion

While the EOS TT-TG measurements were precise and reproducible, they were only moderately comparable to MRI TT-TG measurements. Consequently, EOS TT-TG measurements should not be used for decision-making without the development of EOS-specific TT-TG values that indicate the need for distal realignment surgery.

Level of evidence

Level II.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the Sydney Orthopaedic Research Institute staff for their assistance with this project

Author information

Authors and Affiliations

  1. Sydney Orthopaedic Research Institute, Level 2, 500 Pacific Highway, St. Leonards, Sydney, 2065, Australia

    Geoffrey T. Murphy, Ravi Rudraraju & Alex Nicholls

  2. Westmead Children’s Hospital, Westmead, Australia

    Timothy Mathews, Verinder Sidhu, Alyssa Miller, Kylie Brown & Alex Nicholls

Authors
  1. Geoffrey T. Murphy
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  2. Ravi Rudraraju
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  3. Timothy Mathews
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  4. Verinder Sidhu
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  7. Alex Nicholls
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Corresponding author

Correspondence to Geoffrey T. Murphy.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee Northern Sydney Local Health District Human Research Ethics Committee (HREC 2021/ETH11963).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Murphy, G.T., Rudraraju, R., Mathews, T. et al. The tibial tubercle–trochlear groove distance: a comparison study between EOS and MRI in the paediatric population. Skeletal Radiol 53, 85–91 (2024). https://doi.org/10.1007/s00256-023-04385-6

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  • DOI: https://doi.org/10.1007/s00256-023-04385-6

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