Rehabilitation of Patellofemoral Joint Disorders

Zappala, Frederick G.; Taffel, Cindy B.; Scuderi, Giles R.

doi:10.1016/s0030-5898(20)31771-5

Cited by 45 publications

(3 citation statements)

References 20 publications

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“…At 90° of flexion, approximately the upper third of the articular cartilage contacts the lower trochlear articular cartilage. At 135° of flexion, the medial, lateral and odd patellar facets come in contact with the articular cartilage of the inner medial and lateral femoral condyles [8, 28, 35, 44, 49].…”

Section: Introductionmentioning

confidence: 99%

Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up

Calpur

Özcan

Gürbüz

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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The most important causes of anterior knee pain include patellofemoral malalignment which causes patella-condyle contact anomalies at the patellofemoral joint, excessive patellar lateral pressure increase, trauma and overuse. In this article, besides presentation of late clinical results of 169 lateral retinacular release cases which were surgically treated between January 1995 and December 2002 with the help of a hook knife from the anterolateral portal due to lateral compression syndrome and patellar maltracking, we also described quadriceps tendon pressure-pull test which strongly indicates patellofemoral pain during physical examination of a patient with anterior knee pain. In addition to radiological patellofemoral imaging methods, we describe dynamic arthroscopic patellofemoral joint examination which is applied perarthroscopically to all of our surgically treated patients. We divided the patients into two groups: group 1 was the younger group with age 16-40 years; group 2 was the older group with age >41 years. Preoperative mean Lysholm scores for group I was 67.6 and 98.6, postoperatively, whereas it was 62.3 preoperatively and 91.4 postoperatively in group 2. This improvement of Lysholm scores postoperatively was statistically significant for each of the two groups (p=0.001). For group 1 preoperative IKDC scores were A in 8 patients, B in 61 patients and C in 11 patients, whereas it was A in 78 patients and B in 2 patients postoperatively. For group 2 preoperative IKDC scores were A in 2 patients, B in 43 patients, C in 36 patients and D in 8 patients, whereas it was A in 78 patients and B in 11 patients. This improvement of IKDC scores postoperatively was also statistically significant for each of the two groups (p=0.001). Preoperative and postoperative congruent angles of all patients were also measured. Preoperative mean congruent angle was +16.4 in group 1 while mean congruent angle was -7.1 postoperatively. For group 2 preoperative mean congruent angle was +18.7 preoperatively and -6.9 postoperatively. This improvement was statistically significant for each of the two groups (p=0.001). The overall number of patellar lateral compression syndrome cases were 51 (24 in group 1, 27 in group 2), patellar lateralization cases were 64 (28 in group 1, 36 in group 2) and patellar subluxation cases were 54 (28 in group 1, 26 in group 2). At the evaluation of arthroscopic lateral patellar facet and lateral femoral condylar chondral pathologies, we statistically showed that patellar chondral pathologies were more severe than the femoral chondral pathologies (p=0.001). In our opinion, the severity of patellar lateral facet chondral lesions, although it has a thicker layer of cartilage, is due to distribution of load to a larger contact area of lateral femoral condyle. Statistically increasing severity of femoral (Kendall's tau-b: 0.248, p=0.001) and patellar chondral lesions (Kendall's tau-b: 0.444, p=0.0001) with age is compatible with our arthroscopic and clinical observations. The most important complication s...

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Section: Introductionmentioning

confidence: 99%

Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up

Calpur

Özcan

Gürbüz

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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“…Patellofemoral pain is the most prevalent disorder involving the knee. 7,8,11,17,31 It is generally agreed that patellofemoral pain should be managed initially by nonoperative rather than by operative means. Nonoperative treatments for patellofemoral pain remain varied and controversial.…”

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confidence: 99%

Open Versus Closed Kinetic Chain Exercises for Patellofemoral Pain

et al. 2000

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The goal of this prospective study was to evaluate the efficacy of open versus closed kinetic chain exercises in the nonoperative management of patellofemoral pain. Sixty patients were randomized into a 5-week program that consisted of only closed kinetic chain exercises or only open kinetic chain exercises. Muscle characteristics, subjective symptoms, and functional performance were evaluated in this study at the time of the initial physical examination, at the end of the treatment period, and 3 months later. Both groups experienced a statistically significant decrease in pain and an increase in functional performance. This study shows that both open and closed kinetic chain exercise programs lead to an improved subjective and clinical outcome in patients with anterior knee pain. The few significantly better functional results for some of the tested parameters in the closed kinetic chain group suggest that this type of treatment is a little more effective than the open kinetic chain program in the treatment of these patients.

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“…근력강화 운동 중 등척성 (isometric) 운동은 관절을 무리하게 움직이지 않아 관절 부담이 적고 환자에게 쉽게 근력 향상을 할 수 있어서 많이 사용되는 방법이다 [9]. 또한 PFPS 환자들의 넙다 리네갈래근 등척성 운동은 보행, 일상생활동작 및 기능 훈련의 향상과 통증감소, 근 위축 감소를 위한 목적으로 초기 재활에서 실시해야 할 중요한 운동 치료 중 하나 이다 [10]. 하지 근력운동 시 발목 관절의 자세가 무릎관 절의 역학적인 안정성에 매우 밀접한 영향을 미치며, PFPS 환자는 발목의 위치에 따라 넙다리네갈래근의 활 성도가 달라진다고 하였다 [11].…”

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Comparison of Lower Extremity Muscle Activity According to Ankle Angle during Sling Bridge Exercise in Patients with Patellofemoral Pain Syndrome

Jung

Choi

et al. 2023

Phys Ther Rehabil Sci

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슬개대퇴 통증 증후군(patellofemoral pain syndrome, PFPS)은 주로 8세부터 35세 사이에 호발하며, 운동선수 에게 빈번하며, 남성보다 여성에게서 2배이상 높은 발생 률을 보인다[1, 2]. PFPS는 여러 병리학적 소견 없이 무 릎뼈의 전방 또는 후방에서 통증이 나타나는 것으로 지 속적인 앉기(sitting), 무릎 꿇기(kneeling), 계단 오르내 리기와 쪼그려 앉기 등이 통증을 유발하는 요인으로 작 용한다[3]. 또한 PFPS는 안쪽넓은근(vastus medialis, VM) 과 가쪽넓은근(vastus lateralis, VL)의 불균형으로 무릎 뼈의 불안정성을 유발하고[2], Q-각(quadriceps angle)의 증가와 비정상적인 무릎뼈 정렬, 그리고 과도한 발의 엎 침과 정강이뼈의 과도한 외부 비틀림과 같은 생체역학 적 변화를 가져올 수 있다[4].

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Rehabilitation of Patellofemoral Joint Disorders

Cited by 45 publications

References 20 publications

Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up

Full arthroscopic lateral retinacular release with hook knife and quadriceps pressure-pull test: long-term follow-up

Open Versus Closed Kinetic Chain Exercises for Patellofemoral Pain

Comparison of Lower Extremity Muscle Activity According to Ankle Angle during Sling Bridge Exercise in Patients with Patellofemoral Pain Syndrome

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