The importance of femoral rotation in chondromalacia patellae as shown by serial radiography

Sikorski, JM; Peters, James R.; Watt, Ian

doi:10.1302/0301-620x.61b4.500753

Cited by 34 publications

(17 citation statements)

References 5 publications

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“…However there are so few "normal" patients in this series that no firm conclusion can be drawn and it is an established fact that progressive symptoms of chondromalacia patellae unassociated with apparent faulty biomechanics do exist (Goodfellow et al 1976, Ficat & Hungerford 1977. Patients with this type of idiopathic (or primary) chondromalacia patellae have recently been studied by Sikorski et al (1979) using serial axial radiography under conditions of simulated weight-bearing. In normal controls the femur rotated medially with the onset of muscle activity thus stabilizing the patella; children with a symptomatic patellofemoral joint showed reversal of this reaction, the femur rotating laterally.…”

Section: Discussionmentioning

confidence: 99%

Chondromalacia Patellae:The Relation to Abnormal Patellofemoral Joint Mechanics

Hvid

Andersen

1981

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Chondromalacia Patellae:The Relation to Abnormal Patellofemoral Joint Mechanics

Hvid

Andersen

1981

Acta Orthopaedica Scandinavica

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“…7,54 Although the etiology of PFPS is unclear, some have suggested that the pain and discomfort is likely to be the result of abnormal muscular and biomechanical factors that alter the distribution of shearing and compressive forces on the patellofemoral joint during normal activity. 61 Dye et al 14 recently suggested that the onset of PFPS may be due to a complex pathophysiologic process that may include peripatellar synovitis, increased intraosseous pressure, and increased intraosseous remodeling.…”

mentioning

confidence: 99%

Systematic Review of the Quality of Randomized Controlled Trials for Patellofemoral Pain Syndrome

Bizzini¹,

Childs²,

Piva³

et al. 2003

J Orthop Sports Phys Ther

127

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4Study Design: Systematic review of the literature. Objectives: To develop a grading scale to judge the quality of randomized clinical trials (RCTs) and conduct a systematic review of the published RCTs that assess nonoperative treatments for patellofemoral pain syndrome (PFPS). Background: Systematic reviews of the quality and usefulness of clinical trials allow for efficient synthesis and dissemination of the literature, which should facilitate clinicians' efforts to incorporate principles of evidence-based practice in the clinical decision-making process. Methods and Measures: Using a scale based on criteria in the Cochrane Collaboration Handbook, we sought to critically appraise the methodology used in RCTs related to the nonoperative management of PFPS, synthesize and interpret our results, and report our findings in a user-friendly fashion. A scale to assess the methodological quality of trials was designed and pilot tested for its content and reliability. Published RCTs identified during a literature search were then selected and rated by 6 raters. We used predefined cutoff scores to identify specific weaknesses in the clinical research process that need to be improved in future clinical trials.Results: The quality scale we developed was demonstrated to be sufficiently reliable to warrant interpretation of the reviewers' findings. The percentage of trials that met a minimum level of quality for each specific criterion ranged from a low of 25% for the adequacy of the description of the randomization procedure to a high of 95% for the description and standardization of the intervention. Conclusions: Based on the results of trials exhibiting a sufficient level of quality, treatments that were effective in decreasing pain and improving function in patients with PFPS were acupuncture, quadriceps strengthening, the use of a resistive brace, and the combination of exercises with patellar taping and biofeedback. The use of soft foot orthotics in patients with excessive foot pronation appeared useful in decreasing pain. In addition, at a short-term follow-up, patients who received exercise programs were discharged earlier from physical therapy. Unfortunately, most RCTs reviewed contained qualitative flaws that bring the validity of the results into question, thus diminishing the ability to generalize the results to clinical practice. These flaws were primarily in the areas of randomization procedures, duration of follow-up, control of cointerventions, assurance of blinding, accountability and proper analysis of dropouts, number of subjects, and the relevance of outcomes. Also, given the limited number of high-quality clinical trials, recommendations about supporting or refuting specific treatment approaches may be premature and can only be made with caution.

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“…abnormal soft tissue forces 14,20,32,33 ; increased Q angle 1,19,21 ; tightness, pain, or neuromas in the retinacular structures 8,12,13,30 ; and abnormal tibial and femoral rotation. 33,37 Patients with patella alta 20,34 and patellar subluxation 26 may also be prone to patellofemoral pain.…”

mentioning

confidence: 99%

“…33,37 Patients with patella alta 20,34 and patellar subluxation 26 may also be prone to patellofemoral pain.…”

mentioning

confidence: 99%

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Effects of Foot Orthoses on Quality of Life for Individuals With Patellofemoral Pain Syndrome

Johnston

Gross

2004

J Orthop Sports Phys Ther

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Study Design: Repeated-measures analysis of intervention. Objectives: To determine the effects of foot orthoses on quality of life for individuals with patellofemoral pain who demonstrate excessive foot pronation. Background: Foot orthoses are a common intervention for patients with patellofemoral pain. Limited information is available, however, regarding the effects of foot orthoses on quality of life for these patients. Methods and Measures:Sixteen subjects with patellofemoral pain who also exhibited signs of excessive foot pronation were studied. Subjects underwent a 2-week period of baseline study followed by custom foot orthotic intervention. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was administered to subjects at the time of screening, just prior to foot orthotic intervention, and at 2 weeks and 3 months following foot orthotic intervention. Results: Wilcoxon matched-pairs signed-rank test results indicated statistically significant improvements in the pain and stiffness subscales 2 weeks following the start of foot orthotic intervention. All WOMAC subscale scores were significantly improved at 3 months compared with preintervention measurements. Conclusions: Custom-fitted foot orthoses may improve patellofemoral pain symptoms for patients who demonstrate excessive foot pronation.

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The importance of femoral rotation in chondromalacia patellae as shown by serial radiography

Cited by 34 publications

References 5 publications

Chondromalacia Patellae:The Relation to Abnormal Patellofemoral Joint Mechanics

Chondromalacia Patellae:The Relation to Abnormal Patellofemoral Joint Mechanics

Systematic Review of the Quality of Randomized Controlled Trials for Patellofemoral Pain Syndrome

Effects of Foot Orthoses on Quality of Life for Individuals With Patellofemoral Pain Syndrome

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