Correlation Between Trochlear Groove Depth and Patellar Position During Open and Closed Kinetic Chain Exercises in Subjects With Anterior Knee Pain

2012 ◽  
Vol 28 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Lílian Ramiro Felicio ◽  
Marcelo Camargo Saad ◽  
Rogério Ferreira Liporaci ◽  
Augusto do Prado Baffa ◽  
Antônio Carlos dos Santos ◽  
...  
Keyword(s):  
Knee Pain ◽  
Tilt Angle ◽  
Anterior Knee Pain ◽  
Kinetic Chain ◽  
Pain Group ◽  
Patellar Tilt ◽  
Sulcus Angle ◽  
Closed Kinetic Chain ◽  
Anterior Knee ◽  
Patellar Tilt Angle

The purpose of this study was to correlate the trochlear shape and patellar tilt angle and lateral patellar displacement at rest and maximal voluntary isometric contraction (MVIC) exercises during open (OKC) and closed kinetic chain (CKC) in subjects with and without anterior knee pain. Subjects were all women, 20 who were clinically healthy and 19 diagnosed with anterior knee pain. All subjects were evaluated and subjected to magnetic resonance exams during OKC and CKC exercise with the knee placed at 15, 30, and 45 degrees of flexion. The parameters evaluated were sulcus angle, patellar tilt angle and patellar displacement using bisect offset. Pearson’srcoefficient was used, withp< .05. Our results revealed in knee pain group during CKC and OKC at 15 degrees that the increase in the sulcus angle is associated with a tilt increase and patellar lateral displacement. Comparing sulcus angle, patellar tilt angle and bisect offset values between MVIC in OKC and CKC in the knee pain group, it was observed that patellar tilt angle increased in OKC only with the knee flexed at 30 degrees. Based on our results, we conclude that reduced trochlear depth is correlated with increased lateral patellar tilt and displacement during OKC and CKC at 15 degrees of flexion in people with anterior knee pain. By contrast, 30 degrees of knee flexion in CKC is more recommended in rehabilitation protocols because the patella was more stable than in other positions.

Evaluating Patellar Kinematics Through Magnetic Resonance Imaging During Open- and Closed-Kinetic-Chain Exercises

2010 ◽  
Vol 19 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Lílian Ramiro Felicio ◽  
Marcelo Camargo Saad ◽  
Rogério Ferreira Liporaci ◽  
Augusto do Prado Baffa ◽  
Antônio Carlos dos Santos ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Knee Flexion ◽  
Isometric Contractions ◽  
Resonance Imaging ◽  
Kinetic Chain ◽  
Patellar Tilt ◽  
Patellar Kinematics ◽  
Sulcus Angle ◽  
Closed Kinetic Chain ◽  
Patellar Tilt Angle

Purpose:To evaluate patellar kinematics of volunteers without knee pain at rest and during isometric contraction in open- and closed-kinetic-chain exercises.Methods:Twenty individuals took part in this study. All were submitted to magnetic resonance imaging (MRI) during rest and voluntary isometric contraction (VIC) in the open and closed kinetic chain at 15°, 30°, and 45° of knee flexion. Through MRI and using medical e-film software, the following measurements were evaluated: sulcus angle, patellar-tilt angle, and bisect offset. The mixed-effects linear model was used for comparison between knee positions, between rest and isometric contractions, and between the exercises.Results:Data analysis revealed that the sulcus angle decreased as knee flexion increased and revealed increases with isometric contractions in both the open and closed kinetic chain for all knee-flexion angles. The patellar-tilt angle decreased with isometric contractions in both the open and closed kinetic chain for every knee position. However, in the closed kinetic chain, patellar tilt increased significantly with the knee flexed at 15°. The bisect offset increased with the knee flexed at 15° during isometric contractions and decreased as knee flexion increased during both exercises.Conclusion:VIC in the last degrees of knee extension may compromise patellar dynamics. On the other hand, it is possible to favor patellar stability by performing muscle contractions with the knee flexed at 30° and 45° in either the open or closed kinetic chain.

scholarly journals Relationship of Patellofemoral Angles and Tibiofemoral Rotational Angles With Jumper’s Knee in Professional Dancers: An MRI Analysis

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098522
Author(s):  
Neslihan Aksu ◽  
Vefa Atansay ◽  
Işık Karalök ◽  
Taner Aksu ◽  
Ayhan Nedim Kara ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Tilt Angle ◽  
Patella Alta ◽  
Jumper’S Knee ◽  
Patellar Tilt ◽  
Sulcus Angle ◽  
Significant Difference ◽  
Mri Scans ◽  
Professional Dancers ◽  
Patellar Tilt Angle

Background: Jumper’s knee is a type of tendinopathy affecting the distal insertion of the quadriceps tendon (25% of cases) or the patellar tendon. It has been shown that frontal-plane measurements, such as genu valgum, genu varum, an increased quadriceps angle, a protuberant tibial tuberosity, patella alta, and short hamstring muscles, may be related to jumper’s knee. Purpose: To investigate the effects of tibiofemoral rotational angles and patellofemoral (PF) angles on the development of jumper’s knee in professional folk dancers. Study Design: Case-control study; Level of evidence, 3. Methods: We examined 26 dancers (16 male, 10 female) with knee pain using magnetic resonance imaging (MRI), for a total of 32 knees. Of the knees, 21 with quadriceps tendinopathy (QT) and 7 with patellar tendinopathy (PT) were detected. Using MRI scans, we measured PF angles (PF sulcus angle, lateral PF angle, patellar tilt angle, lateral trochlear inclination angle, lateral patellar tilt angle, and PF congruence angle) and tibiofemoral rotational angles (condylar twist angle, posterior condylar angle, femoral Insall angle, tibial Insall angle, posterior tibiofemoral angle, and angle between the Whiteside line and posterior femoral condylar line) and noted specifics such as patella alta, patella baja, and the Wiberg classification of the patellar shape between the patients with versus without QT and between patients with versus without PT to understand if there was any relationship with tendinopathy. Results: No statistically significant difference was observed in age, sex, patella alta, or the Wiberg classification between the QT groups (with vs without) and between the PT groups (with vs without) ( P > .05). Having QT was found to be significantly associated with the PF sulcus angle ( P = .009), and having PT was found to be significantly associated with the femoral Insall angle ( P = .029). Conclusion: Jumper’s knee was found to be associated with anatomic variations of the PF sulcus angle and rotation of the patellar tendon in relation to the femur (femoral Insall angle) on axial MRI scans in professional dancers. Unlike those of other athletes, dancers’ knees are exposed more to external rotation forces because of turnout, and this can be the cause of jumper’s knee.

scholarly journals The Influence of Mathematical Definitions on Patellar Kinematics Representations

Materials ◽  
2021 ◽  
Vol 14 (24) ◽  
pp. 7644
Author(s):  
Adrian Sauer ◽  
Maeruan Kebbach ◽  
Allan Maas ◽  
William M. Mihalko ◽  
Thomas M. Grupp
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Mean Squared Error ◽  
Patellar Tilt ◽  
Patellar Kinematics ◽  
Kinematic Data ◽  
Squared Error ◽  
Considerable Impact ◽  
Mathematical Definitions ◽  
Anterior Knee

A correlation between patellar kinematics and anterior knee pain is widely accepted. However, there is no consensus on how they are connected or what profile of patellar kinematics would minimize anterior knee pain. Nevertheless, answering this question by merging existing studies is further complicated by the variety of ways to describe patellar kinematics. Therefore, this study describes the most frequently used conventions for defining patellar kinematics, focusing on the rotations. The similarities and differences between the Cardan sequences and angles calculated by projecting axes are analyzed. Additionally, a tool is provided to enable the conversion of kinematic data between definitions in different studies. The choice of convention has a considerable impact on the absolute values and the clinical characteristics of the patello-femoral angles. In fact, the angles that result from using different mathematical conventions to describe a given patello-femoral rotation from our analyses differ up to a Root Mean Squared Error of 111.49° for patellar flexion, 55.72° for patellar spin and 35.39° for patellar tilt. To compare clinical kinematic patello-femoral results, every dataset must follow the same convention. Furthermore, researchers should be aware of the used convention’s implications to ensure reproducibility when interpreting and comparing such data.

scholarly journals Prevalence and Role of Psychiatric Conditions in Patients Diagnosed with Anterior Knee Pain (192)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
Steven Swinehart ◽  
Eric Bowman ◽  
Thomas Freeman ◽  
Andrew Rees ◽  
Holly Harper ◽  
...  
Keyword(s):  
Knee Pain ◽  
Subgroup Analysis ◽  
Anterior Knee Pain ◽  
Demographic Data ◽  
Control Group ◽  
Matched Pairs ◽  
Medication Usage ◽  
Pain Group ◽  
Psychiatric Conditions ◽  
Anterior Knee

Objectives: Anterior knee pain is a common musculoskeletal complaint with a multifactorial etiology. Psychiatric conditions may play a significant role in both the evolution of anterior knee pain and recovery from it. This retrospective, matched case-control study evaluates the prevalence of psychologic conditions in patients with anterior knee pain to assess their role as a potential contributor. Methods: 126 patients with anterior knee pain were retrospectively identified using ICD-10 codes and were individually matched to controls based on gender, age, and BMI. Patient demographics, surgical history, medications, and prior or current diagnoses related to musculoskeletal or psychiatric health were recorded. Demographic data between the anterior knee pain group and controls were evaluated using independent t-tests. Differences between the matched pairs related to psychiatric conditions and medication usage were evaluated using a McNemar Test. A subgroup analysis was also performed and defined by gender, age greater than or less than 35, and BMI greater than or less than 25. Results: Evaluation of demographic data between the anterior knee pain group and controls showed no difference with regards to age, gender, and BMI (p>0.05). Analysis of the 126 matched pairs demonstrated similar rates of psychiatric conditions and medication usage between the anterior knee pain group (23 patients, 18.3%) and the control group (18 patients, 14.3%). Statistically, there was no difference between the two groups (p = 0.472). A subgroup analysis also demonstrated no difference between the anterior knee pain group and controls when stratified by gender (Male [p = 0.80]; Female [p = 0.12]), age (< 35 [p = 1.00]; > 35 [p = 0.50]), and BMI (< 25 [p = 0.10]; > 25 [p = 0.82]). Conclusions: There was no difference in the prevalence of psychiatric conditions between patients with anterior knee pain and their controls. This suggests a low likelihood that the psychologic condition of patients with anterior knee pain differ from that of the general population and implies that psychologic conditions alone are unlikely to play an isolated role in the etiology of anterior knee pain.

Anterior Knee Pain in Children and Adolescents: Overview and Management

2018 ◽  
Vol 31 (05) ◽  
pp. 392-398 ◽  
Author(s):  
Steven Slotkin ◽  
Andrew Thome ◽  
Cassandra Ricketts ◽  
Andrew Georgiadis ◽  
Aristides Cruz ◽  
...  
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellofemoral Instability ◽  
Neuromuscular Control ◽  
Kinetic Chain ◽  
Imaging Studies ◽  
Common Causes ◽  
Growth Changes ◽  
Anterior Knee ◽  
Rule Out

AbstractAnterior knee pain (AKP) is a common presenting complaint for pediatricians and orthopaedic surgeons and is often seen in young athletes. AKP is multifactorial and has a broad differential diagnosis. The growth changes, biomechanics, and anatomy around the knee add to the complexity of diagnosis and treatment of AKP. Common causes of AKP include Osgood–Schlatter's disease, patellar tendinitis, and patellofemoral instability. In the diagnosis of AKP, it is important to rule out serious and morbid causes of pain, including infection and tumor. It is crucial to complete a detailed history and physical examination and obtain appropriate imaging studies. In general, the majority of patients will respond to nonoperative measures targeted to correct neuromuscular control and kinetic chain dysfunction.

120 Genicular Nerve Radio-Frequency Ablation in The Treatment of Anterior Knee Pain in Patients with Osteoarthritis of The Knee Joint: Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Farrugia ◽  
C Tinning
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Comparative Studies ◽  
Primary Outcome ◽  
Final Analysis ◽  
Primary Outcome Measure ◽  
Sensory Innervation ◽  
Osteoarthritis Of The Knee ◽  
Pain Scores ◽  
Anterior Knee

Abstract Anterior knee pain is one of the main symptoms in osteoarthritis, resulting from the rich sensory innervation of its capsule. Pain control can be difficult to achieve, with non-responders to conservative and medical therapy often requiring a total knee replacement. Radiofrequency ablation (RFA) is a novel technique that could be beneficial in managing anterior knee pain by targeting the genicular nerves around the knee; however, its routine use is not included in current guidelines. A literature search identified fifty-two results, which underwent screening using a study protocol and the final literature sources, of varying levels of evidence, underwent critical appraisal and analysis. The primary outcome included the significant improvement of pain scores from baseline, against their respective control treatments. The ten studies included in the final analysis consisted of seven comparative studies and three non-comparative studies. Literature showed significant improvement in their mean pain scores, all meeting the primary outcome measure. Most studies also showed significant improvement from the control treatments used. Current literature shows evidence that genicular nerve RFA is an effective and safe treatment modality in the management of anterior knee pain secondary to osteoarthritis. However, the literature available is limited and further comparative studies are required.

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