An overview of patellofemoral pain—from a tissue homeostasis perspective

Dye, Scott F.; Dye, Christopher C.

doi:10.21037/aoj.2018.04.03

Cited by 61 publications

(97 citation statements)

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“…This repetitive loading could cause supraphysiologic loading of osseous and non-osseous structures potentially causing loss of tissue homeostasis and PFP. 48,49 More research is needed to understand patellofemoral compressive and shear forces and how they are associated with risk of injury.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

Johnston

Baskins

Koppel

et al. 2017

Intl J Sports Phys Ther

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Background:The knee is susceptible to injury during cycling due to the repetitive nature of the activity while generating torque on the pedal. Knee pain is the most common overuse related injury reported by cyclists, and intrinsic and extrinsic factors can contribute to the development of knee pain.Purpose: Due to the potential for various knee injuries, this purpose of this systematic review of the literature was to determine the association between biomechanical factors and knee injury risk in cyclists. Study Design: Systematic review of the literatureMethods: Literature searches were performed using CINAHL, Ovid, PubMed, Scopus and SPORTDiscus. Quality of studies was assessed using the Downs and Black Scale for non-randomized trials.Results: Fourteen papers were identified that met inclusion and exclusion criteria. Only four studies included cyclists with knee pain. Studies were small with sample sizes ranging from 9-24 participants, and were of low to moderate quality. Biomechanical factors that may impact knee pain include cadence, power output, crank length, saddle fore/ aft position, saddle height, and foot position. Changing these factors may lead to differing effects for cyclists who experience knee pain based on specific anatomical location. Conclusion:Changes in cycling parameters or positioning on the bicycle can impact movement, forces, and muscle activity around the knee. While studies show differences across some of the extrinsic factors included in this review, there is a lack of direct association between parameters/positioning on the cycle and knee injury risk due to the limited studies examining cyclists with and without pain or injury. The results of this review can provide guidance to professionals treating cyclists with knee pain, but more research is needed. Level of Evidence: 3a

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Section: Discussionmentioning

confidence: 99%

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

Johnston

Baskins

Koppel

et al. 2017

Intl J Sports Phys Ther

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show abstract

“…In a prospective randomized controlled trial by Grana et al on 84 patients who had either TKA or UKA, 34% (14 of 41) of the TKA group developed patella baja, defined as 10% or more shortening of the patellar tendon postoperatively, compared with 5% (two of 43) in the UKA group. 13,14 The authors associated restricted motion and knee pain with patella baja; lateral release was linked to the development of patella baja (six of seven). In a retrospective review of 1055 consecutive TKAs in 720 patients done by Meneghini et al, the incidence of patella baja was 9.8% (92 of 943).…”

Section: Discussionmentioning

confidence: 99%

Incidence of patella baja following patellar eversion in total knee arthroplasty

et al. 2017

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Background: Patella baja is a rare complication of total knee arthroplasty (TKA) leading to decreased mechanical advantage of the extensor mechanism, decreased knee range of motion, anterior knee pain and increased wear of the tibial and patellar polyethylene. There exists a lack of evidence on whether patellar eversion leads to shortening of the patellar tendon. The present study aims to determine if eversion of patella during TKA leads to patella baja.Methods: Between August 2014 and August 2016, 55 knees undergoing primary TKA with a standard medial parapatellar arthrotomy and eversion of patella were included in this two point cross sectional study. Preoperative X-rays were taken to assess the length of the patellar tendon and Insall Salvati ratio (ISR). Postoperatively the Blackburne Peel Index (BPI), ISR and patellar tendon lengths were assessed on lateral X-rays to look for any incidence of patella baja.Results: The postoperative change in the length of the patellar tendon was unpredictable; though most of them decreased. The pre and post op difference in the length of patellar tendon was statistically significant in females (4.43±0.20 cm vs. 4.35±0.24 cm; p value-0.005). Significant decrease in length of patellar tendon was seen in patients aged 66-70 years (p= 0.024) and patients with BMI >30 kg/m2. No case of true patella baja was found postoperatively. No significant correlation could be established between ISR and age, sex or BMI of the patients.Conclusions: The different risk factors for post TKA shortening of patellar tendon include female gender and higher BMI (>30 Kg/m²). However eversion of patella during TKA may not lead to an increased incidence of true patella baja.

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“…It is proposed that the reduced incidence and spikes during the initial weeks of training is in part a result of the OMEGA programme which was specifically designed to progressively condition the recruits such to avoid a mismatch in physical capacity and applied load. In part, therefore the intent was to facilitate the physical development of the recruits whilst carefully progressively loading tissue within its homeostatic range or within its envelope of function [51]. In this way the aim was to better prepare the recruits for the mandated output tests and to progress through into phase 2 (week 12-26) training with a reduced likelihood of incurring injury.…”

Section: Week Of Injurymentioning

confidence: 99%

A Multicenter Randomized, Double-Blind, Split-Side, Comparative Study of Moisturizer Containing MAS064D and 1% Hydrocortisone Cream in the Treatment of Infantile Seborrheic Dermatitis

Wananukul¹,

Chatproedprai²,

Tempark³

et al. 2018

J Clin Exp Dermatol Res

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An overview of patellofemoral pain—from a tissue homeostasis perspective

Cited by 61 publications

References 0 publications

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

The Influence of Extrinsic Factors on Knee Biomechanics During Cycling: A Systematic Review of the Literature

Incidence of patella baja following patellar eversion in total knee arthroplasty

A Multicenter Randomized, Double-Blind, Split-Side, Comparative Study of Moisturizer Containing MAS064D and 1% Hydrocortisone Cream in the Treatment of Infantile Seborrheic Dermatitis

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