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Using real‐time MRI to quantify altered joint kinematics in subjects with patellofemoral pain and to evaluate the effects of a patellar brace or sleeve on joint motion
Author(s) -
Draper Christine E.,
Besier Thor F.,
Santos Juan M.,
Jennings Fabio,
Fredericson Michael,
Gold Garry E.,
Beaupre Gary S.,
Delp Scott L.
Publication year - 2009
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20790
Subject(s) - brace , medicine , patella , patellofemoral joint , kinematics , weight bearing , knee joint , orthodontics , displacement (psychology) , patellofemoral pain syndrome , tilt (camera) , knee pain , magnetic resonance imaging , physical medicine and rehabilitation , surgery , osteoarthritis , mathematics , physics , radiology , psychology , geometry , alternative medicine , classical mechanics , pathology , psychotherapist , thermodynamics
Abnormal patellofemoral joint motion is a possible cause of patellofemoral pain, and patellar braces are thought to alleviate pain by restoring normal joint kinematics. We evaluated whether females with patellofemoral pain exhibit abnormal patellofemoral joint kinematics during dynamic, weight‐bearing knee extension and assessed the effects of knee braces on patellofemoral motion. Real‐time magnetic resonance (MR) images of the patellofemoral joints of 36 female volunteers (13 pain‐free controls, 23 patellofemoral pain) were acquired during weight‐bearing knee extension. Pain subjects were also imaged while wearing a patellar‐stabilizing brace and a patellar sleeve. We measured axial‐plane kinematics from the images. Females with patellofemoral pain exhibited increased lateral translation of the patella for knee flexion angles between 0°and 50° ( p = 0.03), and increased lateral tilt for knee flexion angles between 0° and 20° ( p = 0.04). The brace and sleeve reduced the lateral translation of the patella; however, the brace reduced lateral displacement more than the sleeve ( p = 0.006). The brace reduced patellar tilt near full extension ( p = 0.001), while the sleeve had no effect on patellar tilt. Our results indicate that some subjects with patellofemoral pain exhibit abnormal weight‐bearing joint kinematics and that braces may be effective in reducing patellar maltracking in these subjects. Published by Wiley Periodicals, Inc. J Orthop Res 27: 571–577, 2009