Frontal Plane Knee and Hip Kinematics During Sit-to-Stand and Proximal Lower Extremity Strength in Persons With Patellofemoral Osteoarthritis: A Pilot Study

Abstract

Increased joint stress and malalignment are etiologic factors in osteoarthritis. Static tibiofemoral frontal plane malalignment is associated with patellofemoral osteoarthritis (PFOA). Patellofemoral joint stress is increased by activities such as sit-to-stand (STS); this stress may be even greater if dynamic frontal plane tibiofemoral malalignment occurs. If hip muscle or quadriceps weakness is present in persons with PFOA, aberrant tibiofemoral frontal plane movement may occur, with increased patellofemoral stress. No studies have investigated frontal plane tibiofemoral and hip kinematics during STS in persons with PFOA or the relationship of hip muscle and quadriceps strength to these motions. Eight PFOA and seven control subjects performed STS from a stool during three-dimensional motion capture. Hip muscle and quadriceps strength were measured as peak isometric force. The PFOA group demonstrated increased peak tibial abduction angles during STS, and decreased hip abductor, hip extensor, and quadriceps peak force versus controls. A moderate inverse relationship between peak tibial abduction angle and peak hip abductor force was present. No difference between groups was found for peak hip adduction angle or peak hip external rotator force. Dynamic tibiofemoral malalignment and proximal lower extremity weakness may cause increased patellofemoral stress and may contribute to PFOA incidence or progression.

Alignment differs between patellofemoral osteoarthritis cases and matched controls: An upright 3D MRI study

“…Clinically, one-legged stance may still be importantdynamic valgus is common with knee pathology, particularly with more demanding functional tasks. [44][45] Our study results suggest that alignment in upright positions in PF OA may be similar to those reported previously using traditional closed-bore scanners. 14 Thus, traditional closed-bore scanners remain clinically useful in the ongoing evaluation of alignment in PF OA in comparison to healthy controls.…”

“…Our results do not justify acquiring images in standing one‐legged, however this has not yet been evaluated at deeper angles of knee flexion, or with participants self‐selecting their position. Clinically, one‐legged stance may still be important—dynamic valgus is common with knee pathology, particularly with more demanding functional tasks …”

Physical performance measurement in persons with patellofemoral osteoarthritis: A pilot study

“…This was part of a cross-sectional study examining frontal plane hip and knee biomechanics during sit-to-stand, pain, and function in persons aged 40-65 years with bilateral, symptomatic, radiographically confirmed PFOA compared to age-and gendermatched, asymptomatic persons without radiographic PFOA in either knee [20]. This portion of the study examined participants' performance on the TUG and a FPW of 50 feet; reports of pain before and following completion of these 2 PPM; and perceived function, stiffness, and pain intensity.…”

“…Eligibility criteria for this study were very strict since the aim was to examine the impact of bilateral symptomatic PFOA, a specific subset of knee OA, on physical performance and pain (Table 1). Study recruitment was previously described [20]. Briefly, 82 potential study participants were referred to the investigators or responded to advertisements.…”

Abnormal Joint Moment Distributions and Functional Performance During Sit‐to‐Stand in Femoroacetabular Impingement Patients

“…Biomechanical assessment of patients with FAI during ADL may provide researchers and clinicians with the knowledge needed PM R 9 (2017) 563-570 www.pmrjournal.org to detect this pathology at an early stage and possibly reduce the adverse effects of this pathology on hip joint health and function. Assessment of biomechanical function during the sitto-stand (STS) task has been performed in patients with patellofemoral joint OA [5], knee joint OA [6][7][8], and hip OA [9], as well as in patients after total hip arthroplasty [10] and in healthy adults [11][12][13][14], but it is yet to be assessed in the FAI population. The STS task has been suggested to be the most mechanically demanding ADL [15] and is performed by adults an average of 60 times per day [11].…”