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This study evaluated whether tibiofemoral rotation in 0° knee extension MRI corresponds to anatomical risk factors for lateral patellar maltracking in PFI patients. Eighty-five consecutive patients underwent bilateral rotational MRI assessment, and correlations tested links between rotation and established anatomical measures.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/increased-tibiofemoral-rotation-is-associated-with-anatomical-risk-factors-for-lateral-patella-instability/460813/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/increased-tibiofemoral-rotation-is-associated-with-anatomical-risk-factors-for-lateral-patella-instability/460813.png","ImageObject",300,407,{"name":92,"@type":93},"Jake","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this study on PFI?","Question",{"text":112,"@type":113},"To determine whether tibiofemoral rotation is associated with anatomical risk factors for patellofemoral maltracking in patients with chronic PFI.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was tibiofemoral rotation measured?",{"text":117,"@type":113},"On standardized bilateral knee MRI in 0° extension, tibiofemoral rotation was calculated as the angle between the posterior femoral condylar tangent and the posterior tibial plateau tangent on axial images.",{"name":119,"@type":110,"acceptedAnswer":120},"Which anatomical risk factors showed significant correlations with tibiofemoral rotation?",{"text":121,"@type":113},"Ipsilateral tibiofemoral rotation correlated with TT–TG and medial posterior cruciate ligament distance (TT–PCL), femoral torsion, and lateral trochlea inclination, while other assessed patellofemoral risk factors showed no correlation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460813,1790764137,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},962084928904,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","DOI: 10.1002/jeo2.70626  \nORIGINAL PA PER  \nIncreased tibiofemoral rotation is associated with anatomical risk factors for lateral patella instability  \nJulius Watrinet1  | Lennart Gerdesmeyer1 | Felix Meurer2 |  \nRomed P. Vieider1 | Armin Runer1 | Sebastian Siebenlist 1  | Lukas Willinger1  \n1Department of Orthopaedic Sports Medicine, TUM University Hospital, Ismaninger, Munich, Germany  \n2Department of Diagnostic and Interventional Radiology, TUM University Hospital, Ismaninger, Munich, Germany  \nCorrespondence  \nJulius Watrinet, Department of Orthopaedic Sports Medicine, TUM University Hospital, Ismaninger Straße 22, Munich 81675, Germany.  \nEmail: [Julius.Watrinet@tum.de](Julius.Watrinet@tum.de)  \nSebastian Siebenlist, Department of Orthopaedic Sports Medicine, TUM University Hospital, Ismaningerstr. 22, Munich 81675, Germany.  \nEmail: [sebastian.siebenlist@mri.tum.de](sebastian.siebenlist@mri.tum.de)  \nAbstract  \nPurpose: Chronic patellofemoral instability (PFI) and pain are influenced by axial malalignment of the patellofemoral joint. Tibiofemoral rotation, defined as the rotation between femur and tibia knee, has shown to be correlated to PFI. This study aimed to determine whether tibiofemoral rotation is associated with anatomical risk factors for patellofemoral maltracking in patients with PFI. It was hypothesised that greater tibiofemoral rotation correlates with other predisposing factors for PFI.  \nMethods: Eighty‐five consecutive patients (mean age 22 .6 ± 8 .9 years; 58 female) with PFI underwent standardised bilateral knee MRI in 0° extension for rotational analysis. Tibiofemoral rotation was measured as the angle between the posterior femoral condylar tangent and posterior tibial plateau tangent on axial images. Ipsilateral and contralateral values along other anatomical patellofemoral risk factors were recorded. One‐sample t‐tests compared to the healthy contralateral side. Pearson correlations assessed associations between tibiofemoral rotation and anatomic risk factors for patellofemoral maltracking.  \nResults: Mean ipsilateral tibiofemoral rotation was 6 .9° ± 6 .0° (range: −6 .5° to 21 .6°) . Contralateral version averaged 6 .4° ± 6 .2° with no significant side difference. Absolute side‐to‐side difference was 3 .7° ± 2 .7° . Ipsilateral tibiofemoral rotation correlated with the tuberositas tibiae–trochlea groove (TT–TG) and medial posterior cruciate ligament distance (TT–PCL) (r =0 .37, p \u003C0 .001, r =0 .43, p \u003C 0 .001), femoral torsion (r = −0 .32, p =0 .003) and lateral trochlea inclination (r = −0 .344, p = 0 .001) whereas other patellofemoral risk factors showed no correlation.  \nConclusion: Tibiofemoral rotation showed a significant correlation with anatomical risk factors associated with lateral patellar maltracking in patients with PFI. Moreover, patients with PFI demonstrated a wide variability in tibiofemoral rotation. Consideration of tibiofemoral rotation may enhance anatomical assessment and aid clinical decision‐making in patients with PFI.  \nLevel of Evidence: Level III.  \n\n| Abbreviations: CI, caton–deschamps index; HKA, hip–knee–ankle angle; ICC, intraclass correlation coefficient; MRI, magnetic resonance imaging; PCL, posterior cruciate ligament; PFI, patellofemoral Instability; Q‐Angle, quadriceps angle; SD, standard deviation; TTO, tibial tubercle osteotomy; TT–PCL, tibial tubercle– posterior cruciate ligament distance; TT–TG, tibial tubercle–trochlear groove distance. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.\u003Cbr>© 2026 The Author(s) . Journal of Experimental Orthopaedics published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy. |\n\nJ Exp Orthop. 2026;13:e70626 . [https://doi.org/10.1002/jeo2.70626](https://doi.org/10.1002/jeo2.70626)  \n[wileyonlinelibrary.com/journa","cbCaivlQ4fZ0KoYh","https://ap.wps.com/l/cbCaivlQ4fZ0KoYh","pdf",1502365,"English","# Abstract\n## Purpose\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What was the purpose of this study on PFI?\",\"answer\":\"To determine whether tibiofemoral rotation is associated with anatomical risk factors for patellofemoral maltracking in patients with chronic PFI.\"},{\"question\":\"How was tibiofemoral rotation measured?\",\"answer\":\"On standardized bilateral knee MRI in 0° extension, tibiofemoral rotation was calculated as the angle between the posterior femoral condylar tangent and the posterior tibial plateau tangent on axial images.\"},{\"question\":\"Which anatomical risk factors showed significant correlations with tibiofemoral rotation?\",\"answer\":\"Ipsilateral tibiofemoral rotation correlated with TT–TG and medial posterior cruciate ligament distance (TT–PCL), femoral torsion, and lateral trochlea inclination, while other assessed patellofemoral risk factors showed no correlation.\"}]","Increased tibiofemoral rotation is associated with anatomical risk factors for lateral patella instability | PDF",1790759674]