Lower extremity rotational deformities and patellofemoral alignment parameters in patients with anterior knee pain

Erkoçak, Ömer Faruk; Altan, Egemen; Altintas, Murat; Türkmen, Faik; Aydın, Bahattin Kerem; Bayar, Ahmet

doi:10.1007/s00167-015-3611-y

Cited by 55 publications

(74 citation statements)

References 49 publications

(94 reference statements)

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“…In contrast to adults, for whom PFP is often assumed to be a kinematic problem, overuse is most often cited as the etiology of pain for adolescent patients. 28, 44, 46, 47, 52 There are a plethora of analyses 6, 9, 12, 24, 37, 50 on patellar tracking and alignment patterns in adults with PFP. Yet, an extensive search of the literature revealed no studies on patellar tracking and just two studies 17, 33 on patellar alignment in adolescents with PFP.…”

Section: Introductionmentioning

confidence: 99%

Patellofemoral Kinematics and Tibial Tuberosity–Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain

2016

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Background Patellofemoral pain is a prevalent disorder among female adolescents. Overuse is frequently cited as the etiology of pain for this population. What is currently unclear, however, is if the patella demonstrates abnormal tracking patterns relative to the femoral trochlear groove in adolescent females with patellofemoral pain. Purpose The aim of this case-control study is to determine if abnormal patellar tracking patterns are present in adolescent females with patellofemoral pain. The secondary aim is to identify if an increased distance between the tibial tuberosity and trochlear groove (TT_TG) is associated with the observed kinematic patterns. Study Design Case Control Methods Twenty female adolescent knees from 12 subjects with patellofemoral pain and 20 age-matched female knees from 13 healthy controls were recruited for this study. Patellofemoral kinematics (e.g., lateral patellar displacement) during a repetitive knee extension-flexion maneuver were quantified from dynamic cine-phase-contrast magnetic resonance imaging techniques. Static magnetic resonance images were used to determine the TT-TG distance. Results Relative to the control cohort, female adolescents with patellofemoral pain demonstrated significantly greater lateral displacement at 10° (3.2mm, p<0.001), 20° (2.3mm, p<0.001), and 30° (1.7mm, p=0.014) of knee flexion. A subgroup within this cohort (7 knees from 5 subjects) demonstrated extreme lateral maltracking >2 standard deviations beyond the average control. This subgroup also demonstrated a greater distance between the tibial tuberosity and trochlear grove relative to controls (Δ=4.2mm, p=0.001). Conclusions This study demonstrates that abnormal patellar tracking patterns are present in adolescent females with patellofemoral pain. Since all subjects from both cohorts participated in impact sports, it appears that rigorous athletic training alone is inadequate to produce symptoms in this population. Rather, patellofemoral pain may derive from a combination of physical activity in the context of pathologic kinematics.

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Section: Introductionmentioning

confidence: 99%

Patellofemoral Kinematics and Tibial Tuberosity–Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain

2016

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“…In another study, it was found a 1.56-fold higher mean femoral anteversion in patients with a history of patellofemoral instability compared with controls. But no signi cant differences in tibial torsion were found in patients with patellofemoral instability compared to the control group in the above two studies [3,4].…”

Section: Introductionmentioning

confidence: 80%

The alignment alteration of transverse plane in growing rabbits after patella dislocation

Niu

Piao

et al. 2020

Preprint

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Background: Torsional malalignment in transverse plan has been regarded as a risk factor for patella dislocation. But the influence of patella dislocation for torsional alignment development remains unknown. The present study aims to investigate whether the torsion alteration of the hindlimb occur after patella dislocation in growing rabbits. Methods : Thirty rabbits that were 1 months old were included in the study. The left knees of each rabbit (N = 30 knees/group), were underwent patella lateral dislocation operation and defined as the experimental group. The right knees of each rabbit, defined as the control group (N =30 knees/group), did not undergo any surgical procedures. Computed tomography was performed on each knee immediately post-surgery and 5 months post-surgery to measure femoral version and tibial torsion. The angles was analyzed between the experimental group and control group. Results : The femoral version and tibia torsion in the experimental and control group were not significantly different immediately after surgery. However, 5 months after surgery, the femoral version of the experimental group (-5.50±6.13°) was significantly different with that of the experimental group (-10.90±4.74°)( P < 0.05). But the tibia angle in the experimental group (7.17±7.25°) and control group (4.47±6.34°) were not significantly different ( P = 0.144). Conclusion : Patella dislocation can lead to significant change in femoral version in growing rabbits. Thus if adolescents suffer from patella dislocation or instability for a long time in growing period, the torsional malalignment in lower limbs may occur.

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“…Так, многими исследованиями доказа-но, что наружная ротация большеберцо-вой кости в значимой степени увеличивает стресс-нагрузку на фасетки надколенника, приводит к ранней нестабильности пателло-феморального сустава и компрессионному болевому синдрому [38,39]. В частности, Lee и соавт.…”

Section: Etiopathogenic Bases For Patellofemoral Arthritis Developmentunclassified

Etiopathogenic bases for patellofemoral arthritis development

Саид

М²,

Akhtyamov

et al. 2018

Kazan Med J

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Patellofemoral arthritis is nowadays an actual issue of traumatology and orthopedics. High prevalence of this pathology around the world (6.9 to 36.1%) is associated with multiple etiological causes, responsible for certain difficulties in diagnosis and complexity of determining an individualized pathogenetic method of treatment. The pathology, often occurring in the young age, is called «delayed or late arthritis», due to the fact that it is often ignored in the early stages of its development. This leads, in the final stages of disease, to manifestation of classic osteoarthritis involving all the structures of the knee joint in the process. The literature review is devoted to the study of etiology, pathogenesis and anatomical features of the development of patellofemoral arthritis. From the clinical point of view, the most important factors, influencing patellofemoral arthritis course, are analyzed. They include mechanisms of the disease, anatomical features of patella, trochlear surface and femoral condyles, which affect the disease course. The article discusses the risk factors of patellofemoral arthritis, such as weakness of vastus muscles of quadriceps femoris, increased knee Q-angle, increased femoral anteversion and tibial rotation, abnormalities of patellar and tibial epicondyles morphology. In addition the study presents some data about dysplasia of the condyles and femoral trochlea and patella, disposition of the patella and dysplasia of the quadriceps. Variations of configuration and position of patella affecting its stability are described and presented. The article also focuses on the influence of internal tibial rotation and femoral anteversion on the development of disease, as well as patellar instability as a multifactorial cause.

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Lower extremity rotational deformities and patellofemoral alignment parameters in patients with anterior knee pain

Abstract: Diagnostic study, Level III.

Cited by 55 publications

References 49 publications

Patellofemoral Kinematics and Tibial Tuberosity–Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain

Patellofemoral Kinematics and Tibial Tuberosity–Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain

The alignment alteration of transverse plane in growing rabbits after patella dislocation

Etiopathogenic bases for patellofemoral arthritis development

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