The Effects of Medialization and Anteromedialization of the Tibial Tubercle on Patellofemoral Mechanics and Kinematics

Abstract

Medialization and anteromedialization are equivalent in their ability to correct abnormal patellar mechanics and kinematics.

Patellofemoral Joint Contact Area Is Influenced by Tibiofemoral Rotation Alignment in Individuals Who Have Patellofemoral Pain

“…This finding is contrary to previously published cadaver studies 17,32 linking patellar alignment and patellofemoral joint contact area. One possible explanation for this discrepancy is that different methodologies were employed.…”

“…The rationale for entering patellar width first was that patellar size would likely influence the magnitude of patellofemoral contact area, thus it was entered as a covariate. Because there is evidence that patellar alignment can influence contact area, 17,32 lateral patellar tilt was entered next. To avoid having multicolinearity among the independent variables, bisect offset index was not used in the regression analysis, as it was highly correlated with lateral patellar tilt (TABLE 2).…”

“…Recent cadaver studies have supported the proposed link between patellar alignment and patellofemoral joint contact area, 17,32 but this relationship has not been substantiated in humans. Furthermore, the role of patellar malalignment in pain development is unclear.…”

Patellofemoral joint contact forces during activities with high knee flexion

“…1 While in vitro experiments have improved the understanding of the mechanisms critical for load sharing between the active and passive structures of the PF joint, [2][3][4][5][6][7][8][9] knowledge of the actual in vivo PF joint forces during activities involving high knee flexion remains limited. 10,11 Computational models of the musculoskeletal system provide access to the internal loads at the tibiofemoral (TF) and PF joints based on external measurements, and can be used to systematically explore the effects of factors relevant to the internal loading conditions.…”

Patellar instability

“…that both procedures corrected elevated patellofemoral contact pressure and resulted in normal patellar tracking 50 . However, neither procedure proved to be superior to the other.…”