Femur Rotation Increases Patella Cartilage Stress in Females with Patellofemoral Pain

Liao, Tzu‐Chieh; Yang, Ning; Ho, Kang-Jey; Farrokhi, Shawn; Powers, Christopher M.

doi:10.1249/mss.0000000000000617

Cited by 70 publications

(42 citation statements)

References 33 publications

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“…Our results support Liao et al series reporting higher patella cartilage stresses on the lateral facet of the patella after 5° and 10° of femoral rotation. [12]. Thus, Lee et al reported changes in kinematic of the PF joint with increased quadriceps muscle strain and increased pressure over the patellar facet at the contralateral side of the rotational deformity [13].…”

Section: Discussionmentioning

confidence: 99%

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Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

et al. 2018

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Section: Discussionmentioning

confidence: 99%

“…PF changes in axial alignment are clinically relevant, especially for anterior knee pain and patellar instability [4,6,12]. However, the influence of stress distribution in anterior pain is controversial, because of the participation of the involved biological factors.…”

Section: Discussionmentioning

confidence: 99%

Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

et al. 2018

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“…Thus, compensatory behavior to accommodate for PFP may have effect on the tibiofemoral joint, as a result of its horizontal orientation, through axial compression (Powers et al, 1999). On the other hand, loading rate would not have strong effects on the patellofemoral joint by nature of its vertical alignment and the fact that patellofemoral compression is primarily dependent on the magnitude of quadriceps force (Maquet, 1984;Powers et al, 1999) and the femur orientation (Liao et al, 2015). Additionally, reduced knee flexion angles in both asymptomatic individuals and individuals with tibiofemoral osteoarthritis have also been linked with a more rapid increase in the ground reaction forces and greater rates of lower limb loading, which make the tibiofemoral joint especially susceptible to disease development and/or progression through increased axial compression and impulse loading (Cook et al, 1997;Mündermann et al, 2005;Radin et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain

Silva

Briani

Pazzinatto

et al. 2015

Clinical Biomechanics

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“…20 Recruiting these muscles would prevent internal rotation of the hip, which has a deleterious effect on patello-femoral mechanics of the knee. 21 Alternatively, the gluteus medius is damaged during a lateral approach to the hip. As mentioned previously, this muscle is a powerful external rotator of the hip.…”

Section: Discussionmentioning

confidence: 99%

Decisional conflict in surgical patients: Should surgeons care?

Petis¹,

Howard²,

Lanting³

et al. 2019

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Background:The choice of surgical approach for total hip arthroplasty (THA) remains a contentious issue with regards to clinical outcome optimization and restoring patient function. The purpose of this study was to determine the impact of surgical approach for THA on quantitative gait analysis. Methods:Patients undergoing THA for primary osteoarthritis of the hip were assigned to 1 of 3 surgical approaches: anterior, posterior and lateral. Standardized implants were used at the time of surgery. Three-dimensional gait analysis was performed preoperatively and at 6 and 12 weeks postoperatively. At each time point, we compared temporal parameters, kinematics and kinetics. Results:We included 30 patients in our analysis (10 anterior, 10 posterior, and 10 lateral). The groups were similar with respect to age (p = 0.27), body mass index (p = 0.16), and Charlson Comorbidity Index score (p = 0.66). Temporal parameters were similar among the groups at all time points. The lateral cohort had higher pelvic tilt during stance on the affected leg than the anterior cohort at 6 weeks (p = 0.041). Affected leg ipsilateral trunk lean during stance was higher in the lateral group than in the other cohorts at 6 weeks (p = 0.008) and 12 weeks (p = 0.040). The anterior and posterior groups showed increased external rotation at 6 weeks (p = 0.003) and 12 weeks (p = 0.012) compared with the lateral group. Conclusion:Temporal gait parameters were similar following THA for all approaches. Differences in gait kinematics and kinetics exist; however, given the small absolute differences, the clinical importance of these changes remains un determined.Contexte : Le choix de l'approche chirurgicale pour la pose d'une prothèse totale de la hanche (PTH) ne fait pas l'unanimité sur le plan de l'optimisation des résultats cliniques et du rétablissement fonctionnel des patients. Le but de cette étude était de déterminer l'incidence de l'approche choisie sur les résultats de l'analyse quantitative de la démarche. Méthodes :Les patients qui se font poser une PTH en raison d'une arthrose primaire de la hanche ont été opérés selon l'une des 3 approches suivantes : antérieure, postérieure ou latérale. Des implants standards ont été utilisés pour la chirurgie. Une analyse tridimensionnelle de la démarche a été effectuée avant l'intervention, puis après 6 et 12 semaines. À chaque étape, nous avons comparé les paramètres temporels, cinématiques et cinétiques. Résultats :Nous avons inclus 30 patients dans notre analyse, soit 10 par approche. Les groupes présentaient des caractéristiques similaires en ce qui concerne l'âge (p = 0,27), l'indice de masse corporelle (p = 0,16) et l'indice de comorbidité de Charlson (p = 0,66). Les paramètres temporels étaient similaires d'un groupe à l'autre à toutes les étapes de l'étude. Six semaines après l'intervention, le groupe opéré selon l'approche latérale présentait une bascule pelvienne à la station debout du côté du membre affecté plus prononcée que le groupe opéré selon l'approche antérieure (p = 0,041). Il présen...

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Femur Rotation Increases Patella Cartilage Stress in Females with Patellofemoral Pain

Abstract: The finding of elevated hydrostatic pressure and octahedral shear stress with internal rotation of the femur supports the premise that females with PFP who exhibit abnormal hip kinematics may be exposed to elevated patellofemoral joint stress.

Cited by 70 publications

References 33 publications

Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study

Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain

Decisional conflict in surgical patients: Should surgeons care?

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