Abstract：
The tip of the tibial tubercle (TTT) is used to assess tibial baseplate rotation in total knee arthroplasty (TKA); however, it can be difficult to palpate and visualize intraoperatively. Several more easily accessible soft-tissue structures have been proposed as intraoperative assessments, including the patellar tendon\'s medial border (MBPT) and the junction of the medial third of the patellar tendon (mt-PT). No studies have described the relationship between the TTT and these proposed landmarks. The aims of the study were to (1) determine the relationship of the soft-tissue landmarks to the TTT and (2) identify any sex differences in these measures. Measurements of the position of these soft-tissue landmarks relative to the TTT were made on 56 cadaveric knees (28 female) by two observers at the level of the standard tibial cut (10 mm distal to the lateral tibial plateau). The results obtained were compared by sex and side. On average, 50.7% (SD 6.79, range 33.1%-63.1%) of the patellar tendon footprint was medial to the TTT. There were no significant differences between the sexes or left and right lower limbs. However, there was large variability in the position of all the soft-tissue landmarks relative to the TTT. The results indicate that, on average, the patellar tendon footprint is evenly spread around the TTT. However, there is a large variability in the anatomical relationship between the soft-tissue landmarks and the TTT. Caution is advised if relying on these structures intraoperatively.
摘要：
胫骨结节（TTT）的尖端用于评估全膝关节置换术（TKA）中的胫骨基板旋转；但是，术中可能难以触诊和观察。已经提出了几种更容易接近的软组织结构作为术中评估，包括髌腱内侧边界（MBPT）和髌腱内侧三分之一的交界处（mt-PT）。没有研究描述TTT与这些建议的地标之间的关系。研究的目的是（1）确定软组织地标与TTT的关系，以及（2）确定这些措施中的任何性别差异。由两名观察者在标准胫骨切口（距胫骨外侧平台10mm）的水平上，在56个尸体膝盖（28个女性）上测量了这些软组织标志相对于TTT的位置。通过性别和侧面比较获得的结果。平均而言,50.7％（SD6.79，范围33.1％-63.1％）的the肌腱足迹位于TTT内侧。性别之间或左右下肢之间没有显着差异。然而,所有软组织标志相对于TTT的位置差异很大.结果表明,平均而言,髌腱足迹均匀地分布在TTT周围。然而,软组织标志和TTT之间的解剖关系存在很大差异。如果术中依赖于这些结构，建议谨慎。
