Load Bearing Characteristics of the Patello-Femoral Joint

Matthews, Larry S.; Sonstegard, David A.; Henke, John A.

doi:10.3109/17453677708989740

Cited by 179 publications

(75 citation statements)

References 6 publications

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“…During deep squatting, the contact area in the patellofemoral joint shifts to the proximal pole of the patella, and the femoral trochlea articulates with the quadriceps tendon (8,24). Biomechanical data support the notion that the patellofemoral contact force is markedly reduced beyond a flexion angle of 90° (25,26). On the other hand, Dahlkvist et al found that the tibiofemoral joint compression forces during a deep squat are ϳ5 times body weight, and the shear force is 3-4 times body weight (7).…”

Section: Discussionmentioning

confidence: 80%

Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: The Beijing Osteoarthritis Study

Hunter¹,

Nevitt²,

Xu³

et al. 2004

Arthritis & Rheumatism

118

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Objective. To examine the association between squatting, a common daily posture in China, and the prevalence of radiographic osteoarthritis (OA) in different knee compartments among Chinese subjects from Beijing, and to estimate how much of the difference in prevalence of knee OA between Chinese subjects in Beijing and white subjects in Framingham, Massachusetts is accounted for by the impact of squatting.Methods. We recruited a random sample of Beijing residents age >60 years. Subjects answered questions on joint symptoms, and knee radiographs were obtained. Subjects were also asked to recall the average amount of time spent squatting each day at age 25 years. Radiographic films (weight-bearing anteroposterior and skyline views) were read for Kellgren/Lawrence (K/L) grade and individual radiographic features. Medial disease was defined when radiographs showed a K/L grade of >2 at the tibiofemoral joint and a medial joint space narrowing score of >1, and lateral disease was assessed in a comparable manner in the lateral compartments. We examined the association of squatting with the prevalence of tibiofemoral OA as well as with the prevalence of patellofemoral knee OA, while adjusting for age and other potential confounding factors. We used the same approach to assess the relationship between squatting and tibiofemoral OA in the medial compartment and in the lateral compartment. Finally, we estimated the impact of squatting at age 25 on the difference in prevalence of knee OA between Chinese subjects in Beijing and white subjects in the Framingham OA Study.Results. Squatting was very common among the Chinese subjects: ϳ40% of men and ϳ68% of women reported squatting >1 hour per day at age 25. The prevalence of tibiofemoral OA increased as the time spent squatting at age 25 increased in both the men and the women. Compared with subjects who squatted <30 minutes per day at age 25, the multivariable-adjusted prevalence odds ratios of tibiofemoral OA were 1.1 for time spent squatting of 30-59 minutes/day, 1.0 for 60-119 minutes/day, 1.7 for 120-179 minutes/day, and 2.0 for >120 minutes/day among the men (P for trend ‫؍‬ 0.074), and the respective odds ratios among the women were 1.4, 1.3, 1.2, and 2.4 (P for trend ‫؍‬ 0.077). A weaker association with patellofemoral OA was found. Prolonged squatting in daily life was more strongly associated with medial knee OA than with lateral disease in the men, but had a similar effect on both knee compartments in the women. After adjusting for the impact of squatting, the age-adjusted difference in prevalence of tibiofemoral OA was reduced from an excess of 14.4% to 9.5% in the Chinese women, but the difference in prevalence of tibiofemoral OA in the Chinese men increased after adjustment for age and squatting, from 2.9% lower to 7.0% lower as compared with their white counterparts.Conclusion. Prolonged squatting is a strong risk factor for tibiofemoral knee OA among elderly Chinese subjects in Beijing, and accounts for a substantial Supported by NIH grants AR-43873 and AR-47785.

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Section: Discussionmentioning

confidence: 80%

Association of squatting with increased prevalence of radiographic tibiofemoral knee osteoarthritis: The Beijing Osteoarthritis Study

Hunter¹,

Nevitt²,

Xu³

et al. 2004

Arthritis & Rheumatism

118

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“…The healthy patella lies proximal to the trochlea at knee extension, enters the trochlear groove as flexion proceeds and translates along the nearly circular arc formed by the patellofemoral groove in the sagittal plane [26,27]. This patellar movement is guided by multiple factors, including the geometry of the trochlear groove, the relative position of the femur with respect to the tibia, contractions of quadriceps muscles and patellar tendon constraints [9,21,22]. Using a biplanar image-matching technique, Asano et al [11] demonstrated movement of the patellar centre point relative to the femur from 0 to 120°flexion in the lateral view, which is consistent with our data.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have explored the patellar kinematics in deeply flexed postures [12,13]. Since an increase in knee flexion angle or quadriceps muscle force during weight-bearing activities will be accompanied by elevated patellofemoral joint reaction forces [22,25], it is important to understand normal patellar mechanics at the higher ranges of flexion.…”

Section: Discussionmentioning

confidence: 99%

“…Matthews et al [22] used serial lateral X-rays of cadaver specimens and fitted the relationship between the quadriceps-patellar tendon angle and the knee flexion angle to a linear regression. Amis et al [23] used fresh-frozen cadaver knees and reported the patella relative to the femur flexed by 0.66 times the tibiofemoral flexion angle as the knee flexed up to 100°.…”

Section: Discussionmentioning

confidence: 99%

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Physiological sagittal plane patellar kinematics during dynamic deep knee flexion

Hamai

Dunbar

Morooka

et al. 2013

International Orthopaedics (SICOT)

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Purpose Lateral radiographic views can be easily taken and have reveal considerable information about the patella. The purpose of this study was to obtain sagittal plane patellar kinematics data through the entire range of knee flexion under weight-bearing conditions. Methods Patellar flexion angles relative to the femur and tibia and anterior-posterior and proximal-distal translations of the patella relative to the femur and tibia were measured from 0 to 165°knee flexion in nine healthy knees using dynamic radiographic images. Results The patella flexed relative to the femur and tibia by two thirds times and one third times the knee flexion angle, respectively. The patella translated in an arc relative to the femur and tibia as the knee flexed. In early flexion, the superior and centroid points translated anteriorly and then the patella translated posteriorly relative to the femur. All three points of the patella translated posteriorly relative to the tibia during a full range of flexion. An average of four and three millimetres proximal patellar translation relative to the tibia was demonstrated from 0 to 20°and 140 to 160°knee flexion, respectively.Conclusions Physiological sagittal plane patellar kinematics, including patellar flexion angles and translations relative to the femur and tibia, showed generally similar patterns for each subject. Measurements of dynamic radiographic images under weight-bearing activities may enhance the opportunity to identify patellar pathological conditions.

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“…This facet does not come into contact until extreme degrees of flexion. Patellofemoral contact areas have been identified on the basis of dye methodology (Goodfellow et al, 1976), radiographic techniques (Matthews et al, 1977), and from pressure transducer measurements in cadaveric specimens . Pressure distribution is transmitted through the vertical ridge separating the lateral and medial facets ) during low degrees of flexion (from 0 to 10 degrees).…”

Section: Knee Joint Contact Areasmentioning

confidence: 99%