Using real‐time MRI to quantify altered joint kinematics in subjects with patellofemoral pain and to evaluate the effects of a patellar brace or sleeve on joint motion

Abstract

Abnormal patellofemoral joint motion is a possible cause of patellofemoral pain, and patellar braces are thought to alleviate pain by restoring normal joint kinematics. We evaluated whether females with patellofemoral pain exhibit abnormal patellofemoral joint kinematics during dynamic, weight-bearing knee extension and assessed the effects of knee braces on patellofemoral motion. Real-time magnetic resonance (MR) images of the patellofemoral joints of 36 female volunteers (13 pain-free controls, 23 patellofemoral pain) were acquired during weight-bearing knee extension. Pain subjects were also imaged while wearing a patellar-stabilizing brace and a patellar sleeve. We measured axial-plane kinematics from the images. Females with patellofemoral pain exhibited increased lateral translation of the patella for knee flexion angles between 08and 508 (p ¼ 0.03), and increased lateral tilt for knee flexion angles between 08 and 208 (p ¼ 0.04). The brace and sleeve reduced the lateral translation of the patella; however, the brace reduced lateral displacement more than the sleeve (p ¼ 0.006). The brace reduced patellar tilt near full extension (p ¼ 0.001), while the sleeve had no effect on patellar tilt. Our results indicate that some subjects with patellofemoral pain exhibit abnormal weight-bearing joint kinematics and that braces may be effective in reducing patellar maltracking in these subjects. ß

Quantitative analysis of dynamic patellar tracking in patients with lateral patellar instability using a simple video system

“…The patella positioned more laterally at 0° than 30° of knee flexion and the displacement in patients was significantly larger than that of controls. After the first report, patellar tracking pattern during active knee extension using various measurement systems such as MRI, ultrasound under various conditions was investigated [11][12][13][14][15][16][17][18][19][20][21]. Our result that patellar tracking in patients with patellar dislocation was significantly larger than that of controls at lower knee flexion angle, in agreement with the previous reports.…”

“…However, the radiation exposure is invasive to subjects and the measurements are acquired only under static conditions at limited knee flexion angles. On the other hand, various methods for quantitative evaluation of dynamic patellar tracking have been projected in previous studies; such as with custom-made devices for cadaveric specimens [11][12][13], dynamic CT [14], open MRI [15][16][17][18][19], ultrasound transducer [20] and optoelectronic motion capture [21]. However, open MRI and these original measurement systems require special facilities and equipments, and take much cost and time.…”

Hyperintense signal alteration in the suprapatellar fat pad on MRI is associated with degeneration of the patellofemoral joint over 48 months: data from the Osteoarthritis Initiative

“…As patellar malalignment has been shown to be associated with knee pain and patellofemoral OA progression [32], baseline MRI examinations of all subjects were also assessed for the following abnormal imaging findings by a board-certified radiologist with 4 years of experience in musculoskeletal radiology (L.F.): a patellar bisect offset of more than 65%, a patellar tilt of more than 9° [33], a patella alta expressed by a modified Insall-Salvati ratio of more than two [34], and a sulcus angle of more than 145° [35,36].…”

Dynamic MRI Assessment of Normal Knee Kinematics

“…Dynamic measurement of knee joint kinematics is a helpful tool because it aids in clinical diagnostics [1][2][3] helps understand sport injury mechanisms [4,5] and is essential in developing implant designs and alignment techniques [6,7]. Movement and load transmission are the main function of the knee joint.…”