Measuring Malalignment on imaging in the treatment of Patell
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When considering TT osteotomy for patellar instability, some surgeons use a TT-TG distance of more than 15 mm or 20 mm as a threshold for performing medialization. The variability is based on the multiple patient and imaging factors that can influence TT-TG distance measurement. We found a 4.2-mm difference in TT-TG distance with the use of different landmarks (central tubercle, anterior tubercle) within the same study population. Therefore, within a practice, the distance used as an indication for TT osteotomy should be measured consistently.

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