Motion of the patella during walking: a video digital-fluoroscopic study in healthy volunteers.

Abstract

The purpose of this study was to determine the movements of the patella in relation to the other bones of the knee joint during normal walking. This is the first study we know of that uses radiographs to show these movements.SUBJECTS AND METHODS. Eight healthy adult volunteers with no previous cornplaints referable to the knee walked on a slowly moving treadmill while their patellae were imaged fluoroscopically in the anteroposterior plane with a Toshiba C-arm. Images were retrieved, transferred to radiographic film, and randomized to prevent the observers from knowing the order of images. The position of the patella was measured and plotted in relation to fixed points of the knee. RESULTS. In each of the subjects at every gait cycle, the patella was observed to move vertically first, followed by a sudden shift to the medial side before returning to its original position. CONCLUSION.Contrary The management of painful and subluxated patellae must be reevaluated in light of this finding. AJR 1993;161 :617-620

Patellar alignment evaluated by MRI

“…As compared to 20" of knee flexion, the bony congruence angle was more negative at 45" knee flexion, which was interpreted as a medial movement of the patella with increasing flexion, as described by Hefzy and Yang (1993), and Stein et al (1993).…”

In vitro simulation and quantification of wear within the patellofemoral joint replacement

“…Sharp increase in force in anticipation of HS as the quadriceps muscles begin to contract to decelerate the leg in preparation for HS (Wallace et al, 1985;Stein et al, 1993;Crenna et al, 2001) and the fact that PFJ force has been shown to proportional to quadriceps activity (van Eijden et al, 1986).…”

The effect of load magnitude on three-dimensional patellar kinematics in vivo

“…Differences in patellar kinematics have been observed between individuals with and without patellofemoral pain (MacIntyre et al, 2006), with patellofemoral pain with and without a brace (Draper et al, 2009), with anterior cruciate ligament deficiency or reconstruction (Shin et al, 2009) and with knee osteoarthritis and varus/valgus leg alignment (McWalter et al, 2007). Non-invasive methods for assessing patellar kinematics have been developed using imaging modalities such as fluoroscopy (Bey et al, 2008;Fregly et al, 2005;Stein et al, 1993), computed tomography (Pinar et al, 1994;Schutzer et al, 1986) and magnetic resonance imaging (MRI) (Fellows et al, 2005a;Patel et al, 2003;Powers et al, 1998;von Eisenhart-Rothe et al, 2004). One advantage of the MRI-based methods is that subjects are not exposed to ionizing radiation, which provides scope for longitudinal study designs.…”