期刊
JOURNAL OF BIOMECHANICS
卷 43, 期 2, 页码 235-241出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.jbiomech.2009.08.043
关键词
Patella; Tracking; In vivo; Kinematics; Patellofemoral pain; Malalignment
资金
- NIAMS NIH HHS [R01 AR056050, R01 AR045634-04, R01 AR056050-01A2] Funding Source: Medline
- NIBIB NIH HHS [F31 EB005169] Funding Source: Medline
- NICHD NIH HHS [R24 HD039627, R24 HD039627-059001] Funding Source: Medline
Patellofemoral pain is a common knee disorder with a multi-factorial etiology related to abnormal patellar tracking. Our hypothesis was that the pattern of three-dimensional rotation and translation of the patella induced by selective activation of individual quadriceps components would differ between subjects with patellofemoral pain and healthy subjects. Nine female subjects with patellofemoral pain and seven healthy female subjects underwent electrical stimulation to selectively activate individual quadriceps components (vastus medialis obliquus, VMO; vastus medialis lateralis, VML: vastus lateralis, VL) with the knee at 0 degrees and 20 degrees flexion, while three-dimensional patellar tracking was recorded. Normalized direction of rotation and direction of translation characterized the relative amplitudes of each component of patellar movement. VMO activation in patellofemoral pain caused greater medial patellar rotation (distal patellar pole rotates medially in frontal plane) at both knee positions (p < 0.01), and both VMO and VML activation caused increased anterior patellar translation (p < 0.001) in patellofemoral pain compared to healthy subjects at 20 degrees knee flexion. VL activation caused more lateral patellar translation (p < 0.001) in patellofemoral pain compared to healthy subjects. In healthy subjects the 3-D mechanical action of the VMO is actively modulated with knee flexion angle while such modulation was not observed in PFP subjects. This could be due to anatomical differences in the VMO insertion on the patella and medial quadriceps weakness. Quantitative evaluation of the influence of individual quadriceps components on patellar tracking will aid understanding of the knee extensor mechanism and provide insight into the etiology of patellofemoral pain. (C) 2009 Elsevier Ltd. All rights reserved.
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