The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions.
Jae-Suk YangMichael FredericsonJang-Hwan ChoiPublished in: PloS one (2020)
Patellofemoral pain (PFP) is commonly caused by abnormal pressure on the knee due to excessive load while standing, squatting, or going up or down stairs. To better understand the pathophysiology of PFP, we conducted a noninvasive patellar tracking study using a C-arm computed tomography (CT) scanner to assess the non-weight-bearing condition at 0° knee flexion (NWB0°) in supine, weight-bearing at 0° (WB0°) when upright, and at 30° (WB30°) in a squat. Three-dimensional (3D) CT images were obtained from patients with PFP (12 women, 6 men; mean age, 31 ± 9 years; mean weight, 68 ± 9 kg) and control subjects (8 women, 10 men; mean age, 39 ± 15 years; mean weight, 71 ± 13 kg). Six 3D-landmarks on the patella and femur were used to establish a joint coordinate system (JCS) and kinematic degrees of freedom (DoF) values on the JCS were obtained: patellar tilt (PT, °), patellar flexion (PF, °), patellar rotation (PR, °), patellar lateral-medial shift (PTx, mm), patellar proximal-distal shift (PTy, mm), and patellar anterior-posterior shift (PTz, mm). Tests for statistical significance (p < 0.05) showed that the PF during WB30°, the PTy during NWB0°, and the PTz during NWB0°, WB0°, and WB30° showed clear differences between the patients with PFP and healthy controls. In particular, the PF during WB30° (17.62°, extension) and the PTz during WB0° (72.50 mm, posterior) had the largest rotational and translational differences (JCS Δ = patients with PFP-controls), respectively. The JCS coordinates with statistically significant difference can serve as key biomarkers of patellar motion when evaluating a patient suspected of having PFP. The proposed method could reveal diagnostic biomarkers for accurately identifying PFP patients and be an effective addition to clinical diagnosis before surgery and to help plan rehabilitation strategies.
Keyphrases
- total knee arthroplasty
- anterior cruciate ligament reconstruction
- computed tomography
- anterior cruciate ligament
- body mass index
- weight loss
- weight gain
- physical activity
- minimally invasive
- image quality
- magnetic resonance imaging
- positron emission tomography
- contrast enhanced
- dual energy
- chronic pain
- end stage renal disease
- polycystic ovary syndrome
- body weight
- ejection fraction
- acute coronary syndrome
- spinal cord injury
- gene expression
- adipose tissue
- pain management
- deep learning
- case report
- type diabetes
- coronary artery disease
- percutaneous coronary intervention
- peritoneal dialysis
- optical coherence tomography
- machine learning
- mass spectrometry
- postmenopausal women
- cervical cancer screening
- pet ct