Changes in patellofemoral joint contact pressures caused by vastus medialis muscle weakness

Sawatsky, Andrew; Bourne, Doug; Horisberger, Monika; Jinha, Azim

doi:10.1016/j.clinbiomech.2011.12.011

Cited by 30 publications

(34 citation statements)

References 35 publications

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“…In addition, these data can be used for validation of, or as input to, future computational models. It is a clear advancement over previous studies that have little to no validation and have typically been limited to static analyses, cadaver studies, animal-based methodologies, or generic computational models [14, 18, 21, 38–40]. …”

Section: Discussionmentioning

confidence: 99%

In vivo patellofemoral contact mechanics during active extension using a novel dynamic MRI-based methodology

Borotikar

Sheehan

2013

Osteoarthritis and Cartilage

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Objectives To establish an in vivo, normative patellofemoral cartilage contact mechanics database acquired during voluntary muscle control using a novel dynamic magnetic resonance (MR) imaging-based computational methodology and validate the contact mechanics sensitivity to the known sub-millimeter methodological inaccuracies. Design Dynamic cine phase-contrast and multi-plane cine images were acquired while female subjects (n=20, sample of convenience) performed an open kinetic chain (knee flexion-extension) exercise inside a 3-Tesla MR scanner. Static cartilage models were created from high resolution three-dimensional static MR data and accurately placed in their dynamic pose at each time frame based on the cine-PC data. Cartilage contact parameters were calculated based on the surface overlap. Statistical analysis was performed using paired t-test and a one-sample repeated measures ANOVA. The sensitivity of the contact parameters to the known errors in the patellofemoral kinematics was determined. Results Peak mean patellofemoral contact area was 228.7±173.6mm2 at 40° knee angle. During extension, contact centroid and peak strain locations tracked medially on the femoral and patellar cartilage and were not significantly different from each other. At 30°, 35°, and 40° of knee extension, contact area was significantly different. Contact area and centroid locations were insensitive to rotational and translational perturbations. Conclusion This study is a first step towards unfolding the biomechanical pathways to anterior patellofemoral pain and OA using dynamic, in vivo, and accurate methodologies. The database provides crucial data for future studies and for validation of, or as an input to, computational models.

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Section: Discussionmentioning

confidence: 99%

In vivo patellofemoral contact mechanics during active extension using a novel dynamic MRI-based methodology

Borotikar

Sheehan

2013

Osteoarthritis and Cartilage

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“…Although Sawatsky et al (2012) have shown that the muscle imbalance associated with PFPS did not cause shifting in the contact pressure, a recent study by Draper et al (2012) has found an increased bone metabolic activity on the medial side for a few subjects. Gorniak (2009) found greater cartilage wear on the medial side than on the lateral side of PF joints of the cadaveric specimen, and Song et al (2011) also reported in their review article that symptomatic patella did not consistently show lateral malalignment or maltracking.…”

Section: Discussionmentioning

confidence: 94%

A geometric approach to study the contact mechanisms in the patellofemoral joint of normal versus patellofemoral pain syndrome subjects

Islam

Duke

Mustafy

et al. 2013

Computer Methods in Biomechanics and Biomedical Engineering

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The biomechanics of the patellofemoral (PF) joint is complex in nature, and the aetiology of such manifestations of PF instability as patellofemoral pain syndrome (PFPS) is still unclear. At this point, the particular factors affecting PFPS have not yet been determined. This study has two objectives: (1) The first is to develop an alternative geometric method using a three-dimensional (3D) registration technique and linear mapping to investigate the PF joint contact stress using an indirect measure: the depth of virtual penetration (PD) of the patellar cartilage surface into the femoral cartilage surface. (2) The second is to develop 3D PF joint models using the finite element analysis (FEA) to quantify in vivo cartilage contact stress and to compare the peak contact stress location obtained from the FE models with the location of the maximum PD. Magnetic resonance images of healthy and PFPS subjects at knee flexion angles of 15°, 30° and 45° during isometric loading have been used to develop the geometric models. The results obtained from both approaches demonstrated that the subjects with PFPS show higher PD and contact stresses than the normal subjects. Maximum stress and PD increase with flexion angle, and occur on the lateral side in healthy and on the medial side in PFPS subjects. It has been concluded that the alternative geometric method is reliable in addition to being computationally efficient compared with FEA, and has the potential to assess the mechanics of PFPS with an accuracy similar to the FEA.

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“…However, the importance of medial ligamentous structures, especially the medial patellofemoral ligament, for patella tracking is well known [20,21]. Although postoperative muscle weakness is a well aired topic, the influence of muscle strength on PF joint kinematics is controversial [21][22][23][24]. We considered that the Values are expressed as mean±SD *P<0.05 Table 2 Comparison of patella shift between pre-and post-operation influence of vastus medialis weakness on PF kinematics in TKA patients is relatively low, compared to a normal knee, because the kinematics were strongly influenced by the design of the prosthesis or its tibio-femoral motion kinematics [25,26].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

Chinzei

Ishida

Matsumoto

et al. 2013

International Orthopaedics (SICOT)

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Purpose ADVANCE® Medial Pivot (MP) (Wright Medical) total knee arthroplasty (TKA) was established to replicate normal tibio-femoral knee joint kinematics, however, its influence on the patello-femoral (PF) joint is unclear. The purpose in this study was to assess the PF joint conditions in Advance MP TKA, via radiography and three-dimensional image-matching software. Methods Ten subjects with osteoarthritis were treated with the ADVANCE MP TKA. Pre-operatively and one month after surgery, skyline views at 30, 60, and 90°of flexion were taken, and patella shift and tilt were measured. With 2D-3D registration techniques using software, implant orientations were matched with the pre-operative CT and changes in the anterior part of the femoral prosthesis, condylar twist angle (CTA) for femoral rotation, and tibial rotation were evaluated. The relationships between morphological and rotational changes were evaluated. Results There were significant differences in patella tilt at 60°a nd patella shift at all angles between pre-and post-operation (p<0.05). No correlation was found between morphological changes in the anterior femur with patella tilt and shift. A positive correlation between postoperative CTA and patella shift at 90°was found (p<0.05); however, no correlation was found between rotational alignment of the tibial component and patella tilt and shift. Conclusions ADVANCE MP TKA changed patello-femoral joint kinematics, compared to that found before surgery. The kinematic features were mainly due to the design concepts for tibio-femoral joint motion, indicating the difficulty to reproduce normal patello-femoral joint kinematics after TKA.

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Changes in patellofemoral joint contact pressures caused by vastus medialis muscle weakness

Cited by 30 publications

References 35 publications

In vivo patellofemoral contact mechanics during active extension using a novel dynamic MRI-based methodology

In vivo patellofemoral contact mechanics during active extension using a novel dynamic MRI-based methodology

A geometric approach to study the contact mechanisms in the patellofemoral joint of normal versus patellofemoral pain syndrome subjects

Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

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