Open AccessIntraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics
Author(s) -
Mikula Jacob D.,
Slette Erik L.,
Dahl Kimi D.,
Montgomery Scott R.,
Dornan Grant J.,
O’Brien Luke,
Turnbull Travis Lee,
Hackett Thomas R.
Publication year - 2017
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-017-0110-8
Subject(s) - medicine , patella , arthrofibrosis , biomechanics , osteoarthritis , contact force , anterior knee pain , anatomy , surgery , range of motion , physics , alternative medicine , pathology , quantum mechanics
Background Arthrofibrosis in the suprapatellar pouch and anterior interval can develop after knee injury or surgery, resulting in anterior knee pain. These adhesions have not been biomechanically characterized. Methods The biomechanical effects of adhesions in the suprapatellar pouch and anterior interval during simulated quadriceps muscle contraction from 0 to 90° of knee flexion were assessed. Adhesions of the suprapatellar pouch and anterior interval were hypothesized to alter the patellofemoral contact biomechanics and increase the patellofemoral contact force compared to no adhesions. Results Across all flexion angles, suprapatellar adhesions increased the patellofemoral contact force compared to no adhesions by a mean of 80 N. Similarly, anterior interval adhesions increased the contact force by a mean of 36 N. Combined suprapatellar and anterior interval adhesions increased the mean patellofemoral contact force by 120 N. Suprapatellar adhesions resulted in a proximally translated patella from 0 to 60°, and anterior interval adhesions resulted in a distally translated patella at all flexion angles other than 15° ( p < 0.05). Conclusions The most important finding in this study was that patellofemoral contact forces were significantly increased by simulated adhesions in the suprapatellar pouch and anterior interval. Anterior knee pain and osteoarthritis may result from an increase in patellofemoral contact force due to patellar and quadriceps tendon adhesions. For these patients, arthroscopic lysis of adhesions may be beneficial.