Medial and Lateral Patellofemoral Joint Retinaculum Thickness in People With Patellofemoral Pain: A Case‐Control Study

Abstract

Objectives To measure the medial and lateral retinaculum thickness in individuals with and without patellofemoral pain using ultrasound and to assess associations with the symptom duration and function. Methods Medial and lateral patellofemoral joint retinaculum thicknesses of 32 knees (16 with patellofemoral pain and 16 asymptomatic) were measured with B‐mode ultrasound at 0.5, 1, and 1.5 cm from the patella border. Participants with patellofemoral pain completed a Kujala questionnaire, and both groups underwent a single‐leg squat performance assessment. Two‐way analyses of variance (site × group) determined the overall effect, and Cohen d values were calculated to describe the magnitude of the difference for each measurement. Results The groups were matched for age, height, and weight. Compared to controls, participants with patellofemoral pain had thicker lateral (overall effect, P = .03) and medial (overall effect, P < 0.01) retinacula. No correlations between retinaculum thickness and Kujala scores (lateral retinaculum, r = 0.106 [0.5 cm], –0.093 [1 cm], and –0.207 [1.5 cm]; and medial retinaculum, r = 0.059, 0.109, and –0.219), symptom duration (lateral retinaculum, r = 0.001, –0.041, and 0.302; and medial retinaculum, r = –0.027, –0.358, and –0.346), or single‐leg squat performance scores (lateral retinaculum, r = 0.051, 0.114, and 0.046; and medial retinaculum, r = –0.119, –0.292, and 0.011) were observed. Conclusions Increased lateral and medial retinaculum thickness in individuals with patellofemoral pain compared to controls identifies structural changes that may be associated with the pathogenesis of patellofemoral pain. The absence of a significant correlation between retinaculum thickness and the symptom duration or function further shows a lack of an association between structure and function in individuals with patellofemoral pain.

Short-term effectiveness of an intervention targeting lower limb range of motion on pain and disability in patellofemoral pain patients: A randomized, non-concurrent multiple-baseline study

“…neovascularization, hyperinnervation, and thickening) and bone of the patella J o u r n a l P r e -p r o o f (e.g. increased intraosseous pressure and decreased arterial blood flow of the patella) were described previously (Dye, 2005;Lack et al, 2018a;Miltner et al, 2003;Näslund et al, 2007;Sanchis-Alfonso, 2014;Schoots et al, 2013). Those changes may be mediated by reduced soft tissue flexibility as a result of structural and inflammatory changes in long-standing PFP (Arnoldi, 1991;Zügel et al, 2018).…”

Taping, Bracing, and Injection Treatment for Patellofemoral Pain and Patellar Tendinopathy

“…Unfortunately, the lateral retinaculum can often exceed medial forces leading to lateral deviation of the patella and thus maltracking. Studies have shown an association with of IT band and lateral retinaculum thickness and tightness to be increased in patient with patellofemoral pain than those without, ultimately leading to patellar maltracking [8][9][10][11][12].…”

Update of Risk Factors, Diagnosis, and Management of Patellofemoral Pain

“…However, if the lateral retinaculum is too taut, theoretically lateral forces overcome medial forces leading to patellar maltracking. When studies have looked at the association of IT band and the lateral retinaculum, they have found it to be tighter and thicker than that of patients without patellofemoral pain, contributing to altered patellar kinematics [32][33][34][35][36].…”

“…It has been shown that persons with PFP have a tighter and thicker iliotibial band compared with pain-free controls. In vivo and cadaveric studies confirm that iliotibial band tension has a significant impact on patellar alignment and tracking, although it is not clear if this tightness and thickening is an adaption to or a cause of patellar lateral tilt [32][33][34][35][36]. Unfortunately, research has not shown stretching alone to be effective and deep soft tissue mobilization may be needed.…”