Differences in patellofemoral kinematics between weight-bearing and non-weight-bearing conditions in patients with patellofemoral pain.
Differences in patellofemoral kinematics between weight-bearing and non-weight-bearing conditions in patients with patellofemoral pain.
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DOI：
10.1002/jor.21253
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发表时间：
2011-03
期刊：
影响因子：
--
通讯作者：
Gold GE
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文献类型：
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作者：
Draper CE;Besier TF;Fredericson M;Santos JM;Beaupre GS;Delp SL;Gold GE
髌骨轨迹不良被认为是髌股关节疼痛的原因之一。髌骨轨迹的测量通常在非负重膝关节伸展期间获得;然而，疼痛通常在高负荷活动期间出现，例如蹲下、爬楼梯和跑步。目前尚不清楚是否髌股关节运动学在轻负荷任务复制髌股关节运动在负重活动。本研究的目的是：评估髌股疼痛患者直立、负重和仰卧、非负重关节运动学之间的差异;并评估追踪不良受试者的运动学对负重的反应是否与非追踪不良者不同。我们使用实时磁共振成像在两种条件下从膝关节屈曲30°到0°的动态膝关节伸展期间可视化髌股关节：直立，负重和仰卧，非负重。我们比较了髌股运动学测量的图像。对于0°至5°的膝关节屈曲角度，与负重任务相比，仰卧任务期间髌骨平移更多（p =0.001）。的maltrackers的运动响应不同的关节负荷比那些非maltrackers。在髌骨过度外侧平移的受试者中，在膝关节屈曲角度在25°和30°之间的直立、负重膝关节伸展期间，髌骨向外侧平移更多（p =0.001）。然而，在髌骨平移正常的受试者中，在接近完全伸展的仰卧、非负重膝关节伸展期间，髌骨平移更外侧（p =0.001）。这些结果表明，髌股关节运动学测量仰卧，无负荷的任务并不能准确地代表关节运动在负重活动。
Patellar maltracking is thought to be one source of patellofemoral pain. Measurements of patellar tracking are frequently obtained during non-weight-bearing knee extension; however, pain typically arises during highly loaded activities, such as squatting, stair climbing, and running. It is unclear whether patellofemoral joint kinematics during lightly loaded tasks replicate patellofemoral joint motion during weight-bearing activities. The purpose of this study was to: evaluate differences between upright, weight-bearing and supine, non-weight-bearing joint kinematics in patients with patellofemoral pain; and evaluate whether the kinematics in subjects with maltracking respond differently to weight-bearing than those in nonmaltrackers. We used real-time magnetic resonance imaging to visualize the patellofemoral joint during dynamic knee extension from 30° to 0° of knee flexion during two conditions: upright, weight-bearing and supine, non-weight-bearing. We compared patellofemoral kinematics measured from the images. The patella translated more laterally during the supine task compared to the weight-bearing task for knee flexion angles between 0° and 5° (p =0.001). The kinematics of the maltrackers responded differently to joint loading than those of the non-maltrackers. In subjects with excessive lateral patellar translation, the patella translated more laterally during upright, weight-bearing knee extension for knee flexion angles between 25° and 30° (p =0.001). However, in subjects with normal patellar translation, the patella translated more laterally during supine, non-weight-bearing knee extension near full extension (p =0.001). These results suggest that patellofemoral kinematics measured during supine, unloaded tasks do not accurately represent the joint motion during weight-bearing activities.