Published: 2016-12-30

Digital analysis of the placement of the tibial tuberosity

Rashmi Bhat, Ramya Rathan, Neha Samapriya, Shakuntala Pai


Background:The tibial tubersosity is a roughened prominence that serves as the attachment site for the ligamentum patellae and typically varies in size and shape. The objective was to determine the vertical and horizontal position of the tibial tuberosity (TT) and determine the side and the gender differences in 170 adult dry tibias.

Methods: 170 randomly collected tibiae of unknown sex were analysed to evaluate the position and the gender differences in the tibia. Horizontal position was assessed using 2 digital photographs of the upper end of the tibia, one being end on view and the other frontal view. The picture thus taken was transferred to the computer and analysed using adobe photoshop version 5.0 software.

Results: There was a significant difference (p value = 0.013) in the horizontal position of TT in end on view. The horizontal position of TT (frontal view) was more laterally placed on the right side than the left which was statistically significant (p value= 0.017, nonparametric test). The horizontal position of TT (end on view) was more laterally placed on the left side than right which was not statistically significant. There was no difference in the vertical position of TT.

Conclusion: From the results, it can be inferred that, the TT is placed more laterally and occupies approximately 6% of the total length of the tibia in all 170 bones.



Tibia, Tibial tuberosity, Horizontal- vertical position

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Scheuer L, Black S. Developmental jeuvenile osteology. Amsterdam. Elsevier Academic Press.2000.

Ljunggren AE. The tuberositas tibiae and extension in the knee joint. Acta Morphol Neerl Scand. 1976;14(3):215-39.

Plaweski S, Petek D, Saragaglia D. Morphometric analysis and functional correlation of tibial and femoral footprints in anatomical and single bundle reconstructions of the anterior cruciate ligament of the knee. Orthop Traumatol Surg Res. 2011;97:S75-9.

Zantop T, Diermann N, Schumacher T, Schanz S, Fu FH et al. Anatomical and nonanatomical double-bundle anterior cruciate ligament reconstruction: importance of femoral tunnel location on knee kinematics. Am J Sports Med. 2008;36:678-85.

Simmons R, Howell SM, Hull ML. Effect of the angle of the femoral and tibial tunnels in the coronal plane and incremental excision of the posterior cruciate ligament on tension of an anterior cruciate ligament graft: an in vitro study. J Bone Joint Surg Am. 2003;85-A(6):1018-29.

Iriuchishima T, Tajima G, Ingham SJ, Shirakura K, Fu FH. PCL to graft impingement pressure after anatomical or non-anatomical single-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc.2012;20:964-9.

Galloway MT, Grood ES, Mehalik JN, Levy M, Saddler SC et al. Posterior cruciate ligament reconstruction. An in vitro study of femoral and tibial graft placement. Am J Sports Med. 1996;24: 437-45.

Singh G, Mohanty C. Asymmetry in the weight and linear measurements of bones of the lower limb. Biomedical research. 2005;16(2):125-7.

Raveendranath V, Nachiket S, Sujatha N, Priya R, Rema R. Gender differences in the mediolateral placement of the patella and tibial tuberosity: a geometric analysis. Anatomy. 2010;4:45-50.