Recurrent patellar dislocations in adolescents result in decreased knee flexion during the entire gait cycle

Abstract

Purpose To evaluate the kinematics/kinetics of the ankle, knee, hip in the sagittal plane in adolescents with recurrent patellar dislocation in comparison to a healthy control. Methods Case-control study. Eighty-eight knees (67 patients) with recurrent patellar dislocation (mean age 14.8 years ± 2.8 SD) were compared to 54 healthy knees (27 individuals, 14.9 years ± 2.4 SD). Kinematics/kinetics of ankle, knee, hip, and pelvis were captured using 3D-gait analysis (VICON, 12 cameras, 200 Hz, Plug-in-Gait, two force plates). One cycle (100%) consisted of 51 data-points. The mean of six trials was computed. ResultsThe loading-response increased by 0.02 s ± 0.01SE (10.8%) with dislocations (0.98% of total gait, P < 0.01). The mid-stance-phase decreased equally (P < 0.01). Dislocation decreased knee flexion during the entire gait cycle (P < 0.01), with the largest difference during mid-stance (9.0° ± 7.2 SD vs. 18.5° ± 6.7 SD). Dislocation increased plantar-flexion during loading response 4.1° ± 0.4 SE with (P < 0.01), afterward, the dorsal-extension decreased 3.2° ± 0.3 SE, (P < 0.01). Dislocation decreased hip flexion during all phases (P < 0.01). Maximal difference: 7.5° ± 0.5 SE during mid-stance. 80% of all patients developed this gait pattern. Internal moments of the ankle increased, of the knee and hip decreased during the first part of stance. Conclusion Recurrent patellar dislocation decreases knee flexion during the loading-response and mid-stance phase. A decreased hip flexion and increased plantar-flexion, while adjusting internal moments, indicate a compensation mechanism. Level of evidence III.

Gait Pathology in Subjects with Patellofemoral Instability: A Systematic Review

“…Almost all the studies [ 24 , 25 , 26 , 28 , 29 , 34 ] achieved a total score of 18 or higher out of a possible total of 22 points for the STROBE checklist. There is only one study by Sowiński et al [ 27 ] where nine of the 22 recommended points of the STROBE checklists were missing.…”

“…The included studies were conducted in different parts of the world, including Poland [ 27 ], the USA [ 25 ], Austria [ 26 , 34 ], the UK [ 29 ], and Switzerland [ 24 , 28 ].…”

“…Several studies investigated the gait pattern in subjects with PI. These studies revealed that subjects with PI show, for instance, decreased gait velocity and cadence and greater internal knee abduction moment than healthy subjects [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. However, some of the studies reported inconsistent/contradictory results, which may indicate the existence of different compensatory gait strategies within subjects with PI due to the multiple influencing factors [ 29 ].…”

Implementation of Machine Learning and Deep Learning Algorithms with Dimensionality Reduction Methods for Internet of Things Gait Analysis and Monitoring Systems

“…There are four commonly observed events in the gait cycle: heel strike (HS), foot flat (FF), heel-off (HO), and toe-off (TO). (19,20) HS is when the heel strikes the ground, FF is when the foot is placed flat on the ground, during which the most weight is applied, HO is when the heel leaves the ground, and TO is when the toe leaves the ground.…”

Complex patellofemoral reconstruction leads to improved physical and sexual activity in female patients suffering from chronic patellofemoral instability

“…Patellofemoral instability (PFI) includes recurrent dislocation and subluxation of the patella with the highest prevalence observed in young females [ 11 , 15 ]. PFI results in significant morbidity and functional impairment with a decreased physical activity level [ 6 , 7 , 11 , 15 , 34 , 36 , 43 ].…”