Patellofemoral Kinematics and Tibial Tuberosity-Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain
Patellofemoral Kinematics and Tibial Tuberosity-Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain
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DOI：
10.1177/0363546516679139
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发表时间：
2017-04-01
影响因子：
4.8
通讯作者：
Sheehan, Frances T.
中科院分区：
文献类型：
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作者：
Carlson, Victor R.;Boden, Barry P.;Sheehan, Frances T.
背景：髌股关节疼痛（PFP）是女性青少年的一种常见疾病。过度使用经常被认为是这一人群疼痛的原因。目前尚不清楚的是，然而，如果髌骨表现出异常的跟踪模式相对于股骨trologiar沟在女性青少年PFP.Purpose：本病例对照研究的目的是，以确定是否异常髌骨跟踪模式存在于女性青少年PFP。次要目的是确定是否增加胫骨结节trophilar沟（TT-TG）的距离与观察到的运动学patterns.Study Design：Controlled laboratory study.Methods：20名女性青少年膝盖从12例PFP和20名年龄匹配的女性膝盖从13名健康对照被招募本研究。通过动态电影相位对比磁共振成像（MRI）对重复膝关节伸展-屈曲动作期间的髌股运动学（例如，髌骨外侧移位）进行量化。静态MRI扫描用于确定TT-TG distance.Results：相对于对照组，患有PFP的女性青少年在膝关节屈曲10度（3.2 mm; P <0.001）、20度（2.3 mm; P <0.001）和30度（1.7 mm; P = 0.014）时表现出显著更大的侧向位移。该队列中的一个亚组（5例患者的7个膝关节）显示出极外侧轨迹不良>对照队列平均值的2个SD。这个亚组也表现出更大的TT-TG距离相对于对照组（三角形= 4.2毫米; P = 0.001）。结论：这项研究表明，在没有髌骨倾斜的情况下，女性青少年PFP的髌骨外侧移位异常。由于两个队列的所有青少年都参加了冲击运动，因此似乎仅进行严格的运动训练不足以在这一人群中产生症状。相反，PFP可能源自病理运动学背景下的身体活动组合。
Background: Patellofemoral pain (PFP) is a prevalent disorder among female adolescents. Overuse is frequently cited as the cause of pain for this population. What is currently unclear, however, is if the patella demonstrates abnormal tracking patterns relative to the femoral trochlear groove in female adolescents with PFP.Purpose: The aim of this case-control study was to determine if abnormal patellar tracking patterns are present in female adolescents with PFP. The secondary aim was to identify if an increased tibial tuberosity-trochlear groove (TT-TG) distance is associated with the observed kinematic patterns.Study Design: Controlled laboratory study.Methods: Twenty female adolescent knees from 12 patients with PFP and 20 age-matched female knees from 13 healthy controls were recruited for this study. Patellofemoral kinematics (eg, lateral patellar displacement) during a repetitive knee extension-flexion maneuver was quantified by dynamic cine phase-contrast magnetic resonance imaging (MRI). Static MRI scans were used to determine the TT-TG distance.Results: Relative to the control cohort, female adolescents with PFP demonstrated significantly greater lateral displacement at 10 degrees (3.2 mm; P < .001), 20 degrees (2.3 mm; P < .001), and 30 degrees (1.7 mm; P = .014) of knee flexion. A subgroup within this cohort (7 knees from 5 patients) demonstrated extreme lateral maltracking >2 SDs of the mean of the control cohort. This subgroup also demonstrated a greater TT-TG distance relative to the controls ( triangle= 4.2 mm; P = .001).Conclusion: This study demonstrates abnormal lateral patellar displacement in the absence of patellar tilt in female adolescents with PFP. Because all adolescents from both cohorts participated in impact sports, it appears that rigorous athletic training alone is inadequate to produce symptoms in this population. Rather, PFP may derive from a combination of physical activity in the context of pathological kinematics.