scholarly journals Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: An upright, weightbearing MRI study

2012 ◽  
Vol 31 (3) ◽  
pp. 448-457 ◽  
Author(s):  
Saikat Pal ◽  
Thor F. Besier ◽  
Gary S. Beaupre ◽  
Michael Fredericson ◽  
Scott L. Delp ◽  
...  
Keyword(s):  
Patellofemoral Pain ◽  
Patella Alta ◽  
Patellar Maltracking ◽  
Mri Study

FULL WEIGHT BEARING KINEMATIC MRI STUDY OF TT-TG DISTANCE: COMPARING PATIENTS WITH PATELLOFEMORAL PAIN TO HEALTHY INDIVIDUALS

2015 ◽  
Vol 21 (4.1) ◽  
pp. 638-642
Author(s):  
Andrius Brazaitis ◽  
Algirdas Tamosiunas ◽  
Janina Tutkuviene
Keyword(s):  
Patellar Instability ◽  
Weight Bearing ◽  
Patellofemoral Pain ◽  
Full Weight Bearing ◽  
Trochlear Groove ◽  
Patellar Tilt ◽  
Full Extension ◽  
Low Degrees ◽  
Mri Study ◽  
Kinematic Magnetic Resonance Imaging

Purpose. The aim of the present study was to investigate tibial tuberosity-trochlear groove (TT-TG) distance dynamics in patients with patellofemoral pain (PFP) and pain free individuals by using full weight bearing kinematic magnetic resonance imaging (MRI) And correlation with patellar instability. Materials and methods. 51 female individuals with PFP and 26 pain free female individuals participated in the study. The kinematic MRI was performed with 1,5 T MRI unit and full-weight bearing. TT-TG distance, bissect offset (BSO) and patellar tilt angle (PTA) were measured in steps of 10° between 50° of flexion to full extension. Results. The TT–TG was higher in PFP patients compared to volunteers’ from 40° to full extension. This difference was statistically significant (p<0.01). PFP patients demonstrated statistically significantly greater TT-TG distance increase from 30° to full extension. BSO and PTA were moderately correlated to TT-TG from 20° of flexion to full extension. Conclusion. TT-TG distance is dynamic and increases significantly during extension in patients with PFP and pain free individuals, depending on knee flexion angle. It shows different pattern of dynamics in PFP group. TT-TG distance is associated with patellar instability (BSO and PTA) at low degrees of flexion.

scholarly journals Clinical Improvement Is Achieved Following Tibial Tubercle Distomedialization for Patellar Maltracking and Patella Alta Without Instability

2021 ◽  
Vol 3 (3) ◽  
pp. e845-e853
Author(s):  
Tarik Bayoumi ◽  
Dennis C. van Duijvenbode ◽  
Joyce L. Benner ◽  
Kirsten D.S. Boerma-Argelo ◽  
Michel H.J. Stavenuiter ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Patella Alta ◽  
Tibial Tubercle ◽  
Patellar Maltracking

scholarly journals Patellar Maltracking Persists in Adolescent Females With Patellofemoral Pain

2017 ◽  
Vol 5 (2) ◽  
pp. 232596711668677 ◽  
Author(s):  
Victor R. Carlson ◽  
Barry P. Boden ◽  
Aricia Shen ◽  
Jennifer N. Jackson ◽  
Katharine E. Alter ◽  
...  
Keyword(s):  
Natural History ◽  
Pain Score ◽  
Three Dimensional ◽  
Patellofemoral Pain ◽  
Adolescent Females ◽  
Physical Activities ◽  
Symptom Improvement ◽  
Patellar Maltracking ◽  
History Of

Background: Patellofemoral pain is one of the most common conditions seen in sports medicine practices, particularly among adolescent females. However, the natural history of the underlying pathology in patellofemoral pain during puberty remains poorly understood. Purpose: The purpose of this longitudinal study is to assess changes in patellar maltracking patterns in subjects with patellofemoral pain as they mature from mid- to late adolescence. Study Design: Cohort study; Level of evidence, 3. Methods: Three-dimensional patellofemoral kinematic data were acquired during active knee extension-flexion using dynamic magnetic resonance imaging in 6 girls (10 knees; mean age, 14.0 years) with clinically diagnosed patellofemoral pain. The subjects then returned as late adolescents (mean age, 18.5 years) for follow-up scanning. Three-dimensional patellofemoral kinematic parameters were evaluated across the range of motion, but comparison between time points was restricted to 10° of flexion. Participation in impact and nonimpact physical activities, pain score based on the visual analog scale, and the anterior knee pain score were also compared across initial and follow-up visits. Results: All subjects reported improved patellofemoral pain symptoms at follow-up, and one subject reported complete resolution. However, relative to the initial visit, no differences were found in patellar maltracking. There was a decrease in hours engaged in impact physical activities for all subjects at follow-up. Conclusion: This study provides insight into the natural history of patellofemoral pain in adolescent females. The relatively unchanged patellofemoral maltracking across subjects suggests that potential anatomic and kinematic abnormalities contributing to patellofemoral pain during mid-adolescence persist during skeletal maturation. Symptom improvement for these subjects did not result from a change in patellofemoral tracking, but rather from other causes.

scholarly journals In vivo strain of the medial vs. lateral quadriceps tendon in patellofemoral pain syndrome

2009 ◽  
Vol 107 (2) ◽  
pp. 422-428 ◽  
Author(s):  
Nicole A. Wilson ◽  
Joel M. Press ◽  
Li-Qun Zhang
Keyword(s):  
Vastus Lateralis ◽  
Knee Extensor ◽  
Pain Syndrome ◽  
Quadriceps Tendon ◽  
Biomechanical Properties ◽  
Patellofemoral Pain ◽  
Control Subjects ◽  
Patellar Maltracking ◽  
Tendon Strain

Patellofemoral pain (PFP) is thought to be related to patellar maltracking due to imbalances in the knee extensor. However, no study has evaluated the in vivo biomechanical properties of the quadriceps tendon in PFP syndrome. Our purpose was to compare the biomechanical properties of the quadriceps tendons in vivo and noninvasively in patients with PFP syndrome to those of control subjects. The null hypothesis was that the quadriceps tendons of PFP subjects would have significantly decreased strain compared with control subjects. Fourteen subjects (7 control, 7 PFP) performed voluntary ramp isometric contractions to a range of torque levels, while quadriceps tendon elongation was measured using ultrasonography. Tendon strain was calculated for the vastus medialis obliquus (VMO) and vastus lateralis (VL) portion of the quadriceps tendon and compared between subjects (control vs. PFP) and within subjects (VMO vs. VL). PFP subjects showed significantly less VMO tendon strain than control subjects ( P < 0.001), but there was no difference in VL tendon strain between PFP and control subjects ( P = 0.100). Relative weakness of the VMO is the most likely cause of the decreased tendon strain seen in subjects with PFP. VMO weakness not only explains the decreased medial tendon strain but also explains the presence of increased lateral patellar translation and lateral patellar spin (distal pole rotates laterally) reported in the literature in this population. This technique can potentially be used in a clinical setting to evaluate quadriceps tendon properties and infer the presence of muscle weakness in PFP.

A Word of Caution for Future Studies in Patellofemoral Pain: A Systematic Review With Meta-analysis

2020 ◽  
pp. 036354652092644
Author(s):  
Camila Grant ◽  
Cameron N. Fick ◽  
Judith Welsh ◽  
Jenny McConnell ◽  
Frances T. Sheehan
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Underlying Mechanism ◽  
Patellofemoral Pain ◽  
Full Extension ◽  
Patellar Maltracking ◽  
Confounding Variables ◽  
Meta Analyses ◽  
Quantitative Definition ◽  
Patellofemoral Kinematics

Background: Patellar maltracking is widely accepted as an underlying mechanism of patellofemoral pain. However, methodological differences in the literature hinder our ability to generate a universal quantitative definition of pathological patellofemoral kinematics (patellar maltracking) in patellofemoral pain, leaving us unable to determine the cause of patellofemoral pain. Purpose: To systematically review the literature to provide evidence regarding the influence of confounding variables on patellofemoral kinematics. Study Design: Systematic review and random effects meta-analysis of control-case studies. Methods: A literature search of case-control studies that evaluated patellofemoral kinematics at or near full extension and were written in English was conducted using Embase, PubMed, Scopus, and Web of Science up to September 2019. Cases were defined as patients with patellofemoral pain. Studies were eliminated if they lacked quantitative findings; had a primary aim to assess therapy efficacy; or included participants with osteoarthritis and/or previous trauma, pathology, or surgery. A quality assessment checklist was employed to evaluate each study. Meta-analyses were conducted to determine the influence of confounding variables on measures of patellofemoral kinematics. Results: Forty studies met the selection criteria, with quality scores ranging from 13% to 81%. Patient characteristics, data acquisition, and measurement methods were the primary sources of methodological variability. Active quadriceps significantly increased lateral shift (standardized mean difference [SMD]shift = 0.33; P = .0102) and lateral tilt (SMDtilt = 0.43; P = .006) maltracking. Individuals with pain secondary to dislocation had greater effect sizes for lateral maltracking than had those with isolated patellofemoral pain (ΔSMDshift = 0.71, P = .0071; ΔSMDtilt = 1.38, P = .0055). Conclusion: This review exposed large methodological variability across the literature, which not only hinders the generalization of results, but ultimately mitigates our understanding of the underlying mechanism of patellofemoral pain. Although our meta-analyses support the diagnostic value of maltracking in patellofemoral pain, the numerous distinct methods for measuring maltracking and the limited control for cofounding variables across the literature prohibit defining a single quantitative profile. Compliance with specific standards for anatomic and outcome measures must be addressed by the scientific and clinical community to establish methodological uniformity in this field.

scholarly journals Sonographic evaluation of patellar tendon displacement and its correlation with patellofemoral pain syndrome

2021 ◽  
Vol 28 ◽  
pp. 221049172110355
Author(s):  
Consuelo B Gonzalez-Suarez ◽  
Cherie-Lee A Apiag ◽  
Kris A. Agarao ◽  
Fe T. Chavez ◽  
Reil V. Espino ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Pain Syndrome ◽  
Potential Method ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Football Players ◽  
Comprehensive Understanding ◽  
Patellar Maltracking ◽  
Significant Difference ◽  
The Difference

Background Patellofemoral pain syndrome is the most common knee condition and is associated with patellar maltracking. Ultrasound is used in studying patellar maltracking. The objective is to determine if the technique which analyzes the displacement of the patellar tendon in the trochlear sulcus is associated with patellofemoral pain syndrome. Methods In total, 68 knees of 34 football players (males = 20, females = 14) were included. Patellar tendon displacement was assessed in supine and standing positions. Patellar tendon displacement difference in the two positions was determined. Results There was a significant difference in the lateral patellar tendon displacement during standing which was larger in patellofemoral pain syndrome than without patellofemoral pain syndrome (Mean Rank = 39.20 vs. 30.32, p = 0.02). There was no significant difference between the two groups for lateral patellar tendon displacement in supine and the difference in patellar tendon displacement from supine to standing. Conclusion The technique could be a potential method in assessing patellar maltracking. It could be used to have a comprehensive understanding of the pathomechanics and treatment of patellofemoral pain syndrome.

Adolescents and adults with patellofemoral pain exhibit distinct patellar maltracking patterns

2021 ◽  
pp. 105481
Author(s):  
Aricia Shen ◽  
Barry P. Boden ◽  
Camila Grant ◽  
Victor R. Carlson ◽  
Katharine E. Alter ◽  
...  
Keyword(s):  
Patellofemoral Pain ◽  
Patellar Maltracking ◽  
Adolescents And Adults

scholarly journals Patellar Maltracking Correlates With Vastus Medialis Activation Delay in Patellofemoral Pain Patients

2010 ◽  
Vol 39 (3) ◽  
pp. 590-598 ◽  
Author(s):  
Saikat Pal ◽  
Christine E. Draper ◽  
Michael Fredericson ◽  
Garry E. Gold ◽  
Scott L. Delp ◽  
...  
Keyword(s):  
Patellofemoral Pain ◽  
Vastus Medialis ◽  
Patellar Maltracking ◽  
Pain Patients ◽  
Activation Delay

scholarly journals A Contemporary Approach to Patellofemoral Pain in Runners

2020 ◽  
Vol 55 (12) ◽  
pp. 1206-1214
Author(s):  
Jean-Francois Esculier ◽  
Kevin Maggs ◽  
Ellora Maggs ◽  
Blaise Dubois
Keyword(s):  
Psychosocial Factors ◽  
Holistic Approach ◽  
Patellofemoral Pain ◽  
Current Evidence ◽  
Patellar Maltracking ◽  
Strengthening Exercises ◽  
Recreational Runners ◽  
The Individual ◽  
Biomechanical Factors ◽  
External Loads

Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.

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