Do sex differences in patellofemoral joint geometry influence quadriceps forces? What are the therapeutic implications?

Abstract

It is widely suggested that women are more at risk of certain types of knee injury. This has prompted a search for sex differences that might explain this increased risk profile. One area that has not received adequate attention is the potential for sex differences in patellofemoral joint geometry. This is notable because even small differences in patellofemoral joint geometry can result in relatively large differences in quadriceps forces. In this paper I review what is known about sex differences in patellofemoral geometry and analyse how such differences might change the loading of the knee. Finally, I indicate how some aspects of patellofemoral geometry might be altered by exercise or therapeutic interventions.

Variation in the patellar tendon moment arm identified with an improved measurement framework

“…The PTMA is correlated with knee size, but sex may also influence it more subtly. Many kinematic, kinetic, and anatomical differences between males and females could affect the PTMA including tibiofemoral rotations, 22 patellar position, 5 patellar tendon tension magnitude and direction, 9,23,24 and trochlear geometry. 25,26 Indeed, extension torque generation capacity has been found to be sex-specific, even after allometric scaling.…”