The Measurement of Patellar Alignment in Patellofemoral Pain Syndrome: Are We Confusing Assumptions With Evidence?

Wilson, Tony

doi:10.2519/jospt.2007.2281

Cited by 102 publications

(80 citation statements)

References 94 publications

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“…Typical symptoms are anterior knee pain exacerbated by activities such as stair descent, prolonged sitting, and squatting. Patellar maltracking and malalignment generally are accepted as leading causes of PF pain [11,15,32,46,49]. However, the relationship between clinical pain and objective measures of patellar malalignment/maltracking is unclear.…”

Section: Introductionmentioning

confidence: 99%

Q-angle and J-sign: Indicative of Maltracking Subgroups in Patellofemoral Pain

Sheehan

Derasari

Fine

et al. 2010

Clinical Orthopaedics &Amp; Related Research

105

103

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Mechanical factors related to patellofemoral pain syndrome and maltracking are poorly understood. Clinically, the Q-angle, J-sign, and lateral hypermobility commonly are used to evaluate patellar maltracking. However, these measures have yet to be correlated to specific three-dimensional patellofemoral displacements and rotations. Thus, we tested the hypotheses that increased Q-angle, lateral hypermobility, and J-sign correlate with three-dimensional patellofemoral displacements and rotations. We also determined whether multiple maltracking patterns can be discriminated, based on patellofemoral displacements and rotations. Three-dimensional patellofemoral motion data were acquired during active extensionflexion using dynamic MRI in 30 knees diagnosed with patellofemoral pain and at least one clinical sign of patellar maltracking (Q-angle, lateral hypermobility, or J-sign) and in 37 asymptomatic knees. Although the Q-angle is assumed to indicate lateral patellar subluxation, our data supported a correlation between the Q-angle and medial, not lateral, patellar displacement. We identified two distinct maltracking groups based on patellofemoral lateral-medial displacement, but the same groups could not be discriminated based on standard clinical measures (eg, Q-angle, lateral hypermobility, and J-sign). A more precise definition of abnormal three-dimensional patellofemoral motion, including identifying subgroups in the patellofemoral pain population, may allow more targeted and effective treatments.

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Section: Introductionmentioning

confidence: 99%

Q-angle and J-sign: Indicative of Maltracking Subgroups in Patellofemoral Pain

Sheehan

Derasari

Fine

et al. 2010

Clinical Orthopaedics &Amp; Related Research

105

103

View full text Add to dashboard Cite

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“…18,28,37 PFP primarily affects younger active individuals between the ages of 18 and 40, 27 and is more common in females. 1,3,10,12,36,42 A typical rehabilitation goal for individuals with PFP is to improve lower extremity strength, especially the strength of the hip and knee contrast, the lateral step-up (LSU) does not replicate a common movement encountered in typical activities of daily living; however, this exercise is often used as part of knee rehabilitation protocols. 4,8,32,45 When designing an appropriate rehabilitation program for individuals with PFP, it is important to select exercises that promote muscle strengthening, while minimizing patellofemoral joint stress (PFJS) and pain.…”

mentioning

confidence: 99%

Patellofemoral Joint Forces and Stress During Forward Step-up, Lateral Step-up, and Forward Step-down Exercises

Chinkulprasert¹,

Vachalathiti²,

Powers³

2011

J Orthop Sports Phys Ther

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“…7 Biomechanical studies describe the movements of the patella and the contact areas and compression forces during movement. 1,3,9,16,17,22,24,26,31,34,37,39,40,45,47,48,50,52,53 During initial flexion (0°-20°), the patella moves medially and the vertical central ridge aligns in the anterior intercondylar groove of the femur. At 20° of flexion, the inferior pole of the patella is in contact with the intercondylar groove and the anterior medial and anterior lateral femoral condyles.…”

mentioning

confidence: 99%

Patterns of Patellofemoral Articular Cartilage Wear in Cadavers

Gorniak¹

2009

J Orthop Sports Phys Ther

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Anatomical studies describe the structure of the articulating bones, the articular cartilage, and the lack of joint congruity. 7,12,17,44,[50][51][52] The triangular patella has a rounded superior pole and a pointed inferior pole (FiGUre 1). Anteriorly, its surface is embedded in the quadriceps tendon. Posteriorly, its surface articulates with t STUdY deSiGn: Descriptive.t oBJeCTiVe: Describe and compare patellar and femoral condylar wear patterns, and the wear frequency of both, relative to each other, gender, and sidedness.t BaCkGroUnd: Studies on normal and pathological patellar cartilage and patellofemoral joint biomechanics are plentiful. However, patellar wear patterns are undefined, as is the relationship of patellar to femoral condylar wear.t MeTHodS: Articular wear was described for 50 patellae and matching femurs from 26 cadavers. Wear locations were transcribed to gridded templates, and these were compared graphically for frequency, gender, and sidedness of wear. The percent frequency of wear was calculated and areas of wear described.t reSULTS: Three patellar and 2 femoral types of wear patterns were observed, and 12 areas of patellar wear and 3 areas of femoral wear described. Patella wear was along the horizontal middle of the patella, with marked medial and odd facet wear. Femoral wear was on the anterior and posterior aspects of the medial condyle, and posterior aspect of the lateral femoral condyle. Patellar and femoral wear frequencies were similar bilaterally, but patellar wear may differ with gender.t ConCLUSionS: Patella and distal femur showed distinct wear patterns. The wear area under the patella matches the contact area between the patella and distal femur normally occurring between 45° to 90° of knee flexion. Patellofemoral assessment and treatment may differ for the aged population because of mechanical changes due to wear.

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The Measurement of Patellar Alignment in Patellofemoral Pain Syndrome: Are We Confusing Assumptions With Evidence?

Cited by 102 publications

References 94 publications

Q-angle and J-sign: Indicative of Maltracking Subgroups in Patellofemoral Pain

Q-angle and J-sign: Indicative of Maltracking Subgroups in Patellofemoral Pain

Patellofemoral Joint Forces and Stress During Forward Step-up, Lateral Step-up, and Forward Step-down Exercises

Patterns of Patellofemoral Articular Cartilage Wear in Cadavers

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