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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2015

01.04.2015 | Knee

Sagittal plane evaluation of patellofemoral movement in patellofemoral pain patients with no evidence of maltracking

verfasst von: Rapeepat Narkbunnam, Keerati Chareancholvanich, Thossart Hanroongroj

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 4/2015

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Abstract

Purpose

The cause of abnormal patellar kinematics in patients with patellofemoral pain remains unclear. Many patients who develop patellofemoral pain symptoms do not exhibit evidence of maltracking. In these patients, sagittal plane evaluation of patellofemoral movement should be performed.

Methods

Knee radiographs were obtained for forty healthy volunteers and thirty patients at 0°, 30°, 60°, 90° and 120° of flexion in a standing weight-bearing position. The degree of active patellar movement was measured by a newly developed technique called “patellar motion angle”. Three independent examiners sequentially performed all of the measurements under identical conditions.

Results

A significant decrease in the patellar motion angle was found during deep knee flexion from 90° to 120° in the patient group compared to the volunteer group (mean 18.5° ± 5.8° and 23.6° ± 6.2°, respectively) (P = 0.001). From 0° to 90° of knee flexion, no significant differences in the patellar motion angle were found between the two groups.

Conclusion

Sagittal plane patellofemoral joint kinematics is an area of interest in the study of the mechanical factors associated with patellofemoral pain. This study demonstrated a decrease in patellar movement during deep knee bending activity in patients with patellofemoral pain.

Level of evidence

Therapeutic study, Level II.
Literatur
1.
Zurück zum Zitat Amis AA, Senavongse W, Bull AM (2006) Patellofemoral kinematics during knee flexion-extension: an in vitro study. J Orthop Res 24:2201–2211CrossRefPubMed Amis AA, Senavongse W, Bull AM (2006) Patellofemoral kinematics during knee flexion-extension: an in vitro study. J Orthop Res 24:2201–2211CrossRefPubMed
2.
Zurück zum Zitat Bennell K, Bartam S, Crossley K, Green S (2002) Outcome measures in patellofemoral pain syndrome: test retests reliability and interrelationships. Phys Ther Sport 1:32–41CrossRef Bennell K, Bartam S, Crossley K, Green S (2002) Outcome measures in patellofemoral pain syndrome: test retests reliability and interrelationships. Phys Ther Sport 1:32–41CrossRef
3.
Zurück zum Zitat Bentley G, Dowd G (1984) Current concepts of etiology and treatment of chondromalacia patellae. Clin Orthop Relat Res 189:209–227PubMed Bentley G, Dowd G (1984) Current concepts of etiology and treatment of chondromalacia patellae. Clin Orthop Relat Res 189:209–227PubMed
4.
Zurück zum Zitat Besier TF, Draper CE, Gold GE et al (2005) Patellofemoral joint contact area increases with knee flexion and weight bearing. J Orthop Res 23:345–350CrossRefPubMed Besier TF, Draper CE, Gold GE et al (2005) Patellofemoral joint contact area increases with knee flexion and weight bearing. J Orthop Res 23:345–350CrossRefPubMed
5.
Zurück zum Zitat Besier TF, Gold GE, Delp SL et al (2008) The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint. J Orthop Res 26(12):1627–1635CrossRefPubMed Besier TF, Gold GE, Delp SL et al (2008) The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint. J Orthop Res 26(12):1627–1635CrossRefPubMed
6.
Zurück zum Zitat Biedert RM, Albrecht S (2006) The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 14(8):707–712CrossRefPubMed Biedert RM, Albrecht S (2006) The patellotrochlear index: a new index for assessing patellar height. Knee Surg Sports Traumatol Arthrosc 14(8):707–712CrossRefPubMed
7.
Zurück zum Zitat Blumensaat C (1938) Die lageabweichungen und verrenkungen der kniescheibe. Ergeb Chir Orthop 31:149–223 Blumensaat C (1938) Die lageabweichungen und verrenkungen der kniescheibe. Ergeb Chir Orthop 31:149–223
8.
Zurück zum Zitat Brattstro¨m H (1963) The picture of the femoro-patellar joint in recurrent dislocation of the patella. Acta Orthop Scand 33:373–375 Brattstro¨m H (1963) The picture of the femoro-patellar joint in recurrent dislocation of the patella. Acta Orthop Scand 33:373–375
9.
Zurück zum Zitat Brechter JH, Powers CM (2002) Patellofemoral stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc 34:1582–1593CrossRef Brechter JH, Powers CM (2002) Patellofemoral stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc 34:1582–1593CrossRef
10.
Zurück zum Zitat Brechter JH, Powers CM (2002) Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait and Posture 16:115–123CrossRefPubMed Brechter JH, Powers CM (2002) Patellofemoral joint stress during stair ascent and descent in persons with and without patellofemoral pain. Gait and Posture 16:115–123CrossRefPubMed
11.
Zurück zum Zitat Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J (2001) Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Archives of Phy Med and Rehab 82:183–189CrossRef Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J (2001) Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Archives of Phy Med and Rehab 82:183–189CrossRef
12.
Zurück zum Zitat Fulkerson JP (ed) (2005) Common patellofemoral problems. American Academy of Orthopaedic Surgeons, Rosemont, IL, pp 19–28 Fulkerson JP (ed) (2005) Common patellofemoral problems. American Academy of Orthopaedic Surgeons, Rosemont, IL, pp 19–28
13.
Zurück zum Zitat Grelsamer RP, Proctor CS, Bazos AN (1994) Evaluation of patellar shape in the sagittal plane: a clinical analysis. Am J Sports Med 22(1):61–66CrossRefPubMed Grelsamer RP, Proctor CS, Bazos AN (1994) Evaluation of patellar shape in the sagittal plane: a clinical analysis. Am J Sports Med 22(1):61–66CrossRefPubMed
14.
Zurück zum Zitat Gruber MA (1979) The conservative treatment of chondromalacia patella. Orthop Clin North Am 10:105–115PubMed Gruber MA (1979) The conservative treatment of chondromalacia patella. Orthop Clin North Am 10:105–115PubMed
15.
Zurück zum Zitat Haim A, Yaniv M, Dekel S, Amir H (2003) Patellofemoral pain syndrome, validity of clinical and radiological features. Clin Orthop Relat Res 451:223–228CrossRef Haim A, Yaniv M, Dekel S, Amir H (2003) Patellofemoral pain syndrome, validity of clinical and radiological features. Clin Orthop Relat Res 451:223–228CrossRef
16.
Zurück zum Zitat Ireland ML, Willson JD, Ballantyne BT, Davis IM (2003) Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther 33:671–676CrossRefPubMed Ireland ML, Willson JD, Ballantyne BT, Davis IM (2003) Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther 33:671–676CrossRefPubMed
17.
Zurück zum Zitat Kannus PA (1992) Long patellar tendon: radiographic sign of patellofemoral pain syndrome: a prospective study. Radiology 185:859–863CrossRefPubMed Kannus PA (1992) Long patellar tendon: radiographic sign of patellofemoral pain syndrome: a prospective study. Radiology 185:859–863CrossRefPubMed
18.
Zurück zum Zitat Kujala UM, Osterman K, Kormano M, Nelimarkka O, Hurme M, Taimela S (1989) Patellofemoral relationships in recurrent patellar dislocation. J Bone Joint Surg Br 71:788–792PubMed Kujala UM, Osterman K, Kormano M, Nelimarkka O, Hurme M, Taimela S (1989) Patellofemoral relationships in recurrent patellar dislocation. J Bone Joint Surg Br 71:788–792PubMed
19.
Zurück zum Zitat Laprade J, Culham E (2003) Radiographic measures in subjects who are asymptomatic and subjects with patellofemoral pain syndrome. Clin Orthop Relat Res 414:172–182CrossRefPubMed Laprade J, Culham E (2003) Radiographic measures in subjects who are asymptomatic and subjects with patellofemoral pain syndrome. Clin Orthop Relat Res 414:172–182CrossRefPubMed
20.
Zurück zum Zitat Laurin CA, Levesque HP, Dussault R et al (1978) The abnormal lateral patellofemoral angle. J Bone Joint Surg Am 60:55–60PubMed Laurin CA, Levesque HP, Dussault R et al (1978) The abnormal lateral patellofemoral angle. J Bone Joint Surg Am 60:55–60PubMed
21.
Zurück zum Zitat MacIntyre NJ, Hill NA, Fellows RA, Ellis RE, Wilson DR (2006) Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome. J Bone Joint Surg Am 88:2596–2605CrossRefPubMed MacIntyre NJ, Hill NA, Fellows RA, Ellis RE, Wilson DR (2006) Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome. J Bone Joint Surg Am 88:2596–2605CrossRefPubMed
22.
Zurück zum Zitat Malek MM, Mangine RE (1981) Patellofemoral pain syndromes: a comprehensive and conservative approach. J Orthop Sports Phys Ther 2:108–116CrossRefPubMed Malek MM, Mangine RE (1981) Patellofemoral pain syndromes: a comprehensive and conservative approach. J Orthop Sports Phys Ther 2:108–116CrossRefPubMed
23.
Zurück zum Zitat McNally EG, Ostlere SJ, Pal C, Phillips A, Reid H, Dodd C (2000) Assessment of patellar maltracking using combined static and dynamic MRI. Eur Radiol 10:1051–1055CrossRefPubMed McNally EG, Ostlere SJ, Pal C, Phillips A, Reid H, Dodd C (2000) Assessment of patellar maltracking using combined static and dynamic MRI. Eur Radiol 10:1051–1055CrossRefPubMed
24.
Zurück zum Zitat Merchant AC (1990) Patellofemoral malalignment and instabilities. In: Ewing JW (ed) Articular cartilage and knee joint function: basic science and arthroscopy. Raven Press Ltd, New York, pp 79–91 Merchant AC (1990) Patellofemoral malalignment and instabilities. In: Ewing JW (ed) Articular cartilage and knee joint function: basic science and arthroscopy. Raven Press Ltd, New York, pp 79–91
25.
26.
Zurück zum Zitat O’Donnell P, Johnstone C, Watson M, McNally E, Ostlere S (2005) Evaluation of patellar tracking in symptomatic and asymptomatic individuals by magnetic resonance imaging. Skeletal Radiol 34:130–135CrossRefPubMed O’Donnell P, Johnstone C, Watson M, McNally E, Ostlere S (2005) Evaluation of patellar tracking in symptomatic and asymptomatic individuals by magnetic resonance imaging. Skeletal Radiol 34:130–135CrossRefPubMed
27.
Zurück zum Zitat Powers CM, Ward SR, Fredericson M et al (2003) Patellofemoral kinematics during weight-bearing and non-weightbearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther 33:677–685CrossRefPubMed Powers CM, Ward SR, Fredericson M et al (2003) Patellofemoral kinematics during weight-bearing and non-weightbearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther 33:677–685CrossRefPubMed
28.
Zurück zum Zitat Reider B (1999) The orthopaedic physical examination. In: Reider B (ed) The knee. WB Saunders Company, Philadelphia, pp 201–248 Reider B (1999) The orthopaedic physical examination. In: Reider B (ed) The knee. WB Saunders Company, Philadelphia, pp 201–248
29.
Zurück zum Zitat Selfe J (2000) Peak 5 motion analysis of an eccentric step test performed by 100 normal subjects. Physiotherapy 86:241–247CrossRef Selfe J (2000) Peak 5 motion analysis of an eccentric step test performed by 100 normal subjects. Physiotherapy 86:241–247CrossRef
30.
Zurück zum Zitat Stickland A (1985) Examination of the knee joint. Physiotherapy 70:144–150 Stickland A (1985) Examination of the knee joint. Physiotherapy 70:144–150
31.
Zurück zum Zitat Waldron VD (1983) A test for chondromalacia patellae. Orthop Rev 12:103 Waldron VD (1983) A test for chondromalacia patellae. Orthop Rev 12:103
32.
Zurück zum Zitat Wilson NA, Press JM, Koh JL (2009) In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am 91:558–566CrossRefPubMedCentralPubMed Wilson NA, Press JM, Koh JL (2009) In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am 91:558–566CrossRefPubMedCentralPubMed
Metadaten
Titel
Sagittal plane evaluation of patellofemoral movement in patellofemoral pain patients with no evidence of maltracking
verfasst von
Rapeepat Narkbunnam
Keerati Chareancholvanich
Thossart Hanroongroj
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 4/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2782-7

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