Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact.

Huberti, Helmut H.; Hayes, Wilson C.

doi:10.2106/00004623-198466050-00010

Cited by 738 publications

(421 citation statements)

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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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“…A thin patella can reduce patellofemoral contact force but also poses the potential risk of stress fracture and anteroposterior instability [8,16]. Increasing patellar thickness might be expected to increase effective quadriceps moment arm at low flexion angles of the knee but potentially reduces range of motion and predisposes to patellar subluxation [9,12]. It commonly is assumed that it is desirable for a resurfaced patella to be equal to its original thickness [1,6,8,13,16], and a bony patellar thickness of at least 15 mm should be maintained [16].…”

Section: Introductionmentioning

confidence: 99%

Clinical Implications of Anthropometric Patellar Dimensions for TKA in Asians

Kim

Chung

Kang

et al. 2008

Clin Orthop Relat Res

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Anthropometric patellar dimensions can influence implant design and surgical techniques in patellar resurfacing for TKA. We measured anthropometric patellar dimensions in 752 osteoarthritic knees (713 in females and 39 in males) treated with TKA in 466 Korean patients and compared them with reported dimensions for Western patients. We investigated the effects of postoperative overall thickness deviations, residual bony thickness after bone resection, and postoperative deviations of component center positions from median ridge positions versus clinical and radiographic outcomes evaluated 1 year after surgery. Korean patients undergoing TKA had thinner and smaller patellae than Western patients. We found no associations between preoperative to postoperative overall thickness differences and clinical and radiographic outcomes and no differences between knees with a residual bony thickness 12 mm or greater and knees with a residual thickness less than 12 mm, with the exception of WOMAC pain scores. We found no associations between postoperative deviations of component center position and clinical or radiographic outcomes. Our findings indicate bone resection for patellar resurfacing can be flexible without jeopardizing clinical outcome.

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“…39 This movement pattern is thought to increase frontal plane loading of the knee and the dynamic quadriceps angle, resulting in lateral tracking of the patella and abnormal loading of the patellofemoral joint. 6,18,22,27,33,34 Several studies suggest that females with PFPS demonstrate weakness of the musculature that controls hip adduction, hip internal rotation, contralateral pelvic drop, and knee external rotation. 2,4,7,19,39,40 Thus hip strengthening is often advocated to improve hip mechanics, 26 with the intent of reducing the incidence of, or symptoms related to, PFPS.…”

mentioning

confidence: 99%

The Effect of a Hip-Strengthening Program on Mechanics During Running and During a Single-Leg Squat

Willy

Davis

2011

J Orthop Sports Phys Ther

202

152

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Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact.

Cited by 738 publications

References 0 publications

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

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

Clinical Implications of Anthropometric Patellar Dimensions for TKA in Asians

The Effect of a Hip-Strengthening Program on Mechanics During Running and During a Single-Leg Squat

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