August 08, 2017
1 min read

BLOG: TT-TG distance and our criteria for a tibial tubercle transfer

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John P. Fulkerson
John P. Fulkerson

Carlson and colleagues recently wrote: “The static [tibial tubercle to trochlear groove] TT-TG distance cannot accurately predict dynamic lateral displacement of the patella. A large percentage of patients with patellofemoral pain and pathologically large TT-TG distances may have neutral to medial maltracking patterns.”

Those doing patellofemoral surgery should review and discuss this. Of course, this raises questions about our criteria for doing tibial tubercle transfer. Don’t we want to do a tibial tubercle transfer to correct lateral tracking? Not too sure the TT-TG in isolation is reliable enough for surgical decision-making.


Carlson VR, et al. Am J Sports Med. 2017;doi:10.1177/0363546517700119.

John P. Fulkerson, MD, is a clinical professor of orthopedic surgery at the University of Connecticut School of Medicine and practices at Orthopedic Associates of Hartford in Farmington, Connecticut. He is also president of The Patellofemoral Foundation.

Disclosure: Fulkerson reports he receives royalties from DJO Global and is a patent holder for DJO Global.