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In‐vivo patellar tracking in individuals with patellofemoral pain and healthy individuals
Author(s) -
Esfandiarpour Fateme,
Lebrun Constance M.,
Dhillon Sukhvinder,
Boulanger Pierre
Publication year - 2018
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.23887
Subject(s) - patella , medicine , supine position , patellofemoral pain syndrome , patellofemoral joint , fluoroscopy , knee flexion , knee joint , orthodontics , surgery , alternative medicine , pathology
Understanding of the exact cause of patellofemoral pain has been limited by methodological challenges to evaluate in‐vivo joint motion. This study compared six degree‐of‐freedom patellar motion during a dynamic lunge task between individuals with patellofemoral pain and healthy individuals. Knee joints of eight females with patellofemoral pain and ten healthy females were imaged using a CT scanner in supine lying position, then by a dual‐orthogonal fluoroscope while they performed a lunge. To quantify patellar motion, the three‐dimensional models of the knee bones, reconstructed from CT scans, were registered on the fluoroscopy images using the Fluomotion registration software. At full knee extension, the patella was in a significantly laterally tilted (PFP: 11.77° ± 7.58° vs. healthy: 0.86° ± 4.90°; p = 0.002) and superiorly shifted (PFP: 17.49 ± 8.44 mm vs. healthy: 9.47 ± 6.16 mm, p = 0. 033) position in the patellofemoral pain group compared with the healthy group. There were also significant differences between the groups for patellar tilt at 45°, 60°, and 75° of knee flexion, and for superior‐inferior shift of the patella at 30° flexion ( p ≤ 0.031). In the non‐weight‐bearing knee extended position, the patella was in a significantly laterally tilted position in the patellofemoral pain group (7.44° ± 6.53°) compared with the healthy group (0.71° ± 4.99°). These findings suggest the critical role of passive and active patellar stabilizers as potential causative factors for patellar malalignment/maltracking. Future studies should investigate the associations between patellar kinematics with joint morphology, muscle activity, and tendon function in a same sample for a thorough understanding of the causes of patellofemoral pain. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2193–2201, 2018.