Chondromalacia Patellae:<i>The Relation to Abnormal Patellofemoral Joint Mechanics</i>

Hvid, Ivan; Andersen, Lars Ib

doi:10.3109/17453678108992164

Cited by 92 publications

(49 citation statements)

References 15 publications

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“…Our findings are consistent with already strong evidence to support greater mean standing quadriceps angle in females compared to males 1,23,26,28,31,84 ; however, there is poor agreement on what should be considered an "abnormal value." While the American Orthopaedic Association 3 considers a standing quadriceps angle of 10° to be normal and angles 15° to 20° to be abnormal, these values appear to be based on clinical observation and do not account for differences by sex.…”

Section: Quadriceps Anglesupporting

confidence: 80%

“…1,23,26,28,43,73,84 When these sex differences are considered, angles greater than 15° for men and greater than 20° for women have been suggested as clinically abnormal. 26,31 Our values would appear to be somewhat consistent with these outer limits, as mean values of 17° and 22° represent values that exceed 2 standard deviations of the mean for males and females, respectively, in our study population.…”

Section: Quadriceps Anglesupporting

confidence: 49%

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Sex Differences in Clinical Measures of Lower Extremity Alignment

Nguyen¹,

Shultz²

2007

J Orthop Sports Phys Ther

167

135

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Selected lower limb injuries and, in particular, those of the knee have been reported to occur in greater prevalence in females compared to males. 4,29,49,60,61,85 Sex differences in lower extremity alignment (LEA) have been included among a myriad of risk factors as a potential cause for the prevalence of knee injury in females. 21,29,34,33,47 Anecdotally, females have been cited as having greater anterior pelvic tilt, femoral anteversion, tibiofemoral angle, quadriceps angle, genu recurvatum, tibial torsion, and foot pronation. 21,29 However, apart from the measure of quadriceps angle, there is little empirical data to support these sex differences in a healthy population.While the literature consistently demonstrates greater mean quadriceps angles in females, 1,23,24,26,28,84 limited studies support a sex difference in mean pelvic tilt 24 and genu recurvatum. 81 Conversely, no sex differences have been observed with measures of tibial torsion 57,77 and foot pronation as measured by navicular drop 6,24,51,81 t StuDy DeSign: Descriptive, cohort design.t ObJectiveS: To comprehensively examine sex differences in clinical measures of static lower extremity alignment (LEA).t bAckgrOunD: Sex differences in LEA have been included among a myriad of risk factors as a potential cause for the increased prevalence of knee injury in females. While clinical observations suggest that sex differences in LEA exist, little empirical data are available to support these sex differences or the normal values that should be expected in a healthy population.t MethODS AnD MeASureS: The right and left static LEA of 100 healthy college-age participants (50 males [mean 6 SD age, 23.3 6 3.6 years; height, 177.8 6 8.0 cm, body mass, 80.4 6 11.6 kg] and 50 females [mean 6 SD age, 21.8 6 2.5 years; height, 164.3 6 6.9 cm; body mass, 67.4 6 15.2 kg]) was measured. Each alignment characteristic was analyzed via separate repeated-measures analyses of variance, with 1 between-subject factor (sex) and 1 within-subject factor (side).t reSultS: There were no significant sex-byside interactions and no differences between sides. Females had greater mean anterior pelvic tilt, hip anteversion, quadriceps angles, tibiofemoral angles, and genu recurvatum than males (P<.0001). No sex differences were observed in tibial torsion (P = .131), navicular drop (P = .130), and rearfoot angle (P = .590).t cOncluSiOn: Sex differences in LEA indicate that females, on average, have greater anterior pelvic tilt, thigh internal rotation, knee valgus, and genu recurvatum. These sex differences were not accompanied by differences in the lower leg, ankle, and foot. Understanding these collective sex differences in LEA may help us to better examine the influence of LEA on dynamic lower extremity function and clarify their role as a potential injury risk factor.

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Section: Quadriceps Anglesupporting

confidence: 80%

Section: Quadriceps Anglesupporting

confidence: 49%

Sex Differences in Clinical Measures of Lower Extremity Alignment

Nguyen¹,

Shultz²

2007

J Orthop Sports Phys Ther

167

135

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“…It is commonly believed that a Q angle of 156 in men and 206 in women is excessive and may lead to disorders at the knee. 36 However, these values have been disputed as being somewhat arbitrary. 9 Nonetheless, the means and SDs of the Q angle values in our sample were less than those values.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

McKeon

Hertel

2009

Journal of Athletic Training

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Context: A discrepancy in anterior cruciate ligament (ACL) injury rates exists between men and women. Structural differences between the sexes often are implicated as a factor in this discrepancy. Researchers anecdotally assume that men and women tend to display different normative values for certain lower extremity alignments, but published information about these values is limited.Objective: To evaluate the effect of sex on 6 measures of lower extremity alignment and to report representative values of these measures from a sample of active adults and elite athletes.Design: Descriptive cohort design. Setting: University research laboratory. Patients or Other Participants: A total of 118 healthy adults (57 men: age 5 21.1 6 3.0 years, height 5 179.1 6 7.3 cm, mass 5 79.8 6 13.0 kg; 61 women: age 5 20.0 6 1.6 years, height 5 167.7 6 6.7 cm, mass 5 62.7 6 5.5 kg) volunteered.Main Outcome Measure(s): Six common measures of lower extremity posture (navicular drop, tibial varum, quadriceps angle, genu recurvatum, anterior pelvic tilt, femoral anteversion) were collected using established methods. One measurement was taken for each participant for each lower extremity alignment. We measured the right lower extremity only.Results: Compared with men, women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion.Conclusions: We observed differences between men and women for 4 of the 6 lower extremity alignments that we measured. Future researchers should focus on identifying how sex and skeletal alignment affect biomechanical performance of functional tasks and what these differences specifically mean regarding the discrepancy in anterior cruciate ligament injury rates between the sexes.Key Words: malalignment, femoral anteversion, genu recurvatum, anterior pelvic tilt, quadriceps angle Key Points N Women demonstrated larger quadriceps angles, more genu recurvatum, greater anterior pelvic tilt, and more femoral anteversion compared with men.N We found no sex difference for navicular drop or tibial varum. N Because the sex differences for 4 measures of alignment were small, we cannot decisively conclude that alignment contributes to lower extremity injury.N Further investigation is needed to determine how lower extremity alignment affects the rate of lower extremity injuries.

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“…Measurement is sometimes limited only to the right limb [37,38] or the limb affected by symptoms [39]. Hvid et al [32] provide information about symmetrical occurrence of the Q angle in both limbs; 29 men and women with patella pain took part in the research, and no differences in the Q angle for the right and left limb for any examined person were found. Neither did Messier et al [40] depict any statistically significant differences between the sides in their study involving a 16-person group.…”

Section: Discussionmentioning

confidence: 99%

“…The authors of other studies concerning the value of the Q angle in the knee joint most often delineate data for a single person [31,32] or a group of people [33][34][35][36]. Measurement is sometimes limited only to the right limb [37,38] or the limb affected by symptoms [39].…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic evaluation and comparison of articular cartilage of the femur condyles between the limbs in patients with an elevated Q angle

Kusiak¹,

Kawczyński²

2018

Physiother Quart.

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Introduction. TPatellofemoral pain may be caused by an increase of the pressure of the joint surfaces in the patella and the femur, and, as a consequence, a premature abrasion of joint cartilage. The aim of the study was an ultrasonographic evaluation and comparison of articular cartilage of the femur condyles between the limbs in patients with an elevated Q angle.Methods. The total of 13 women aged 35-45 years with the Q angle exceeding 15° took part in the research. The measurement of the Q angle was carried out with a goniometer.

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Chondromalacia Patellae:The Relation to Abnormal Patellofemoral Joint Mechanics

Cited by 92 publications

References 15 publications

Sex Differences in Clinical Measures of Lower Extremity Alignment

Sex Differences in Clinical Measures of Lower Extremity Alignment

Sex Differences and Representative Values for 6 Lower Extremity Alignment Measures

Ultrasonographic evaluation and comparison of articular cartilage of the femur condyles between the limbs in patients with an elevated Q angle

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