Tibiofemoral and patellofemoral mechanics are altered at small knee flexion angles in people with patellofemoral pain
Tibiofemoral and patellofemoral mechanics are altered at small knee flexion angles in people with patellofemoral pain
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DOI：
10.1016/j.jsams.2012.04.003
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发表时间：
2013-01-01
影响因子：
4
通讯作者：
Perman, William H.
中科院分区：
文献类型：
--
作者：
Salsich, Gretchen B.;Perman, William H.
Objectives: To test the hypothesis that, at 0 degrees and 20 degrees of knee flexion, patellofemoral contact area would be lower, while tibiofemoral rotation and patellofemoral malalignment would be higher in participants with patellofemoral pain (PFP) compared to pain-free participants. We hypothesized that no differences would be detected at 40 degrees due to increasing patellar stability.Design: Cross-sectional, descriptive study.Methods: Twenty-seven people with PFP and 29 pain-free people participated. Participants underwent magnetic resonance imaging at 0 degrees, 20 degrees, and 40 degrees knee flexion with the limb in a simulated weight-bearing position. Patellofemoral contact area, tibiofemoral rotation angle, patellofemoral alignment (bisect offset index and patellar tilt angle) were quantified and compared between groups at each angle using Student's t-tests. An a-posteriori comparison was made between the pain-free group and a subgroup of 15 participants with patellofemoral pain who demonstrated a faulty lower limb movement pattern ("medial collapse").Results: In the patellofemoral pain group, contact area was lower at 0 degrees (203.8 +/- 45.5 mm(2) vs. 224.1 +/- 46.6 mm(2), p = 0.05) and 20 degrees (276.8 +/- 56.2 mm(2) vs. 316.7 +/- 82.8 mm(2), p = 0.02), bisect offset index (BOS) and patellar tilt angle (PTA) were higher at 0 degrees (bisect offset index: 0.69 +/- 0.13 vs. 0.64 +/- 0.09, p = 0.04; patellar tilt angle: 12.5 +/- 7.6 degrees vs. 9.2 +/- 5.8 degrees, p = 0.04). In the patellofemoral pain subgroup, tibiofemoral rotation was higher at 0 degrees compared to pain-free participants (6.4 +/- 5.9 degrees vs. 4.0 +/- 4.6 degrees, p = 0.07).Conclusions: While contact area and patellofemoral alignment were altered in people with patellofemoral pain, tibiofemoral rotation was altered in a subgroup of people who demonstrated medial collapse. Subgroup classification may help identify mechanisms of pain and assist in developing targeted interventions. (C) 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
