J Orthop Res. 2018 Feb 28; doi: 10.1002/jor.23887. Epub 2018 Feb 28.
In-vivo patellar tracking in individuals with patellofemoral pain and healthy individuals.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
Fateme Esfandiarpour, Constance M Lebrun, Sukhvinder Dhillon, Pierre Boulanger
Affiliations
Affiliations
- Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada.
- Musculoskeletal Rehabilitation Research Center, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.
- Department of Computing Science, University of Alberta, Edmonton, Canada.
PMID: 29488245
DOI: 10.1002/jor.23887
Abstract
Understanding of the exact cause of patellofemoral pain has been limited by methodological challenges to evaluate in-vivo joint motion. This study compared six degree-of-freedom patellar motion during a dynamic lunge task between individuals with patellofemoral pain and healthy individuals. Knee joints of eight females with patellofemoral pain and ten healthy females were imaged using a CT scanner in supine lying position, then by a dual-orthogonal fluoroscope while they performed a lunge. To quantify patellar motion, the three-dimensional models of the knee bones, reconstructed from CT scans, were registered on the fluoroscopy images using the Fluomotion registration software. At full knee extension, the patella was in a significantly laterally tilted (PFP: 11.77° ± 7.58° vs. healthy: 0.86° ± 4.90°; p = 0.002) and superiorly shifted (PFP: 17.49 ± 8.44 mm vs. healthy: 9.47 ± 6.16 mm, p = 0. 033) position in the patellofemoral pain group compared with the healthy group. There were also significant differences between the groups for patellar tilt at 45°, 60°, and 75° of knee flexion, and for superior-inferior shift of the patella at 30° flexion (p ≤ 0.031). In the non-weight-bearing knee extended position, the patella was in a significantly laterally tilted position in the patellofemoral pain group (7.44° ± 6.53°) compared with the healthy group (0.71° ± 4.99°). These findings suggest the critical role of passive and active patellar stabilizers as potential causative factors for patellar malalignment/maltracking. Future studies should investigate the associations between patellar kinematics with joint morphology, muscle activity, and tendon function in a same sample for a thorough understanding of the causes of patellofemoral pain. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
© 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Keywords: biplane fluoroscopy; knee injuries; patellofemoral joint; patellofemoral pain syndrome
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