Editorial Commentary: Sunset View: Time to Retire Tibial Tubercle-Trochlear Groove Thresholds for Patellar Instability

Orthopaedic literature often establishes cutoffs when evaluating risk factors for an outcome of interest, whether patellar instability or most any other pathology. Although such cutoffs are intuitively easy to apply to clinical practice and testing situations, they leave much to be desired when it comes to nuanced patient care. As we increasingly recognize patient-to-patient differences, our approach to historic cutoffs such as tibial tubercle-trochlear groove distance merits a revisit. A reasonable first step is to adjust for patient-specific factors such as height and sex. However, as larger datasets and deeper mechanistic insights become available, we may ultimately move beyond simplistic thresholds altogether, advancing instead toward truly individualized precision medicine.