Multivariate Analysis of Associations between Patellofemoral Instability and Gluteal Muscle Contracture: A Radiological Analysis.

Qihang Su,Jie Li,Biao Cheng,Yi Zhang,Chao Xue,Hengan Ge,Yuanzhen Zhang

doi:10.3390/jpm12020242

Abstract

The purpose of this study was to investigate the associations between gluteal muscle contracture (GMC) severity and patellofemoral instability and evaluate the reliability of novel indicators by multivariate analysis. Clinical and imaging data from 115 patients with GMC were collected for retrospective analysis. Two novel indicators were used to evaluate GMC severity (knee flexion angle and hip flexion angle, feet distance), and two additional novel parameters were used to reflect patellofemoral instability [patellar displacement vector (L, α), patella-femoral trochlear (P-FT) area, and femoral-trochlear-patella (FT-P) area]. In this study, patients with moderate contracture were dominant, and 35.65% also experienced anterior knee pain after physical activity. Ordered logistic regression analysis indicated that a more serious GMC represented a higher risk of lateral tilt and lateral displacement of the patella. Multivariate analysis showed that feet distance was a reliable indicator for evaluating the severity of GMC. The results showed that the more serious the GMC, the more significant the difference between the P-FT area and the FT-P area of the patellofemoral joint space. L, patellar tilt angle, patellar congruency angle, and lateral patellofemoral angle were independent risk factors for this difference. A more serious GMC represents a higher risk of patellar subluxation.

Highlights

Gluteal muscle contracture (GMC) is a clinical syndrome characterized by limited hip joint function attributed to gluteal muscle and corresponding fascia contracture
Multivariate analysis was conducted to investigate the impact of differing severities of GMC on patellofemoral instability by combining routine assessment parameters relating to patellofemoral instability and new assessment indicators designed by our research group
We combined a range of assessment indicators and performed multivariate analysis to evaluate the association between GMC classification and patellofemoral instability

Summary

Introduction

Gluteal muscle contracture (GMC) is a clinical syndrome characterized by limited hip joint function attributed to gluteal muscle and corresponding fascia contracture. As is well-known nationwide, the diagnosis and treatment of GMC are parts of the characteristic specialties of our group-affiliated department, and on average, 2–3 GMC patients visit the hospital every week In our hospital, such patients are mainly treated with minimally invasive therapy by arthroscopic GMC release [5]. The vast majority of patients complain of an inability to squat down while closing their knees together or crossing their legs upon arrival. Most of these patients present with knee pain or discomfort; this is aggravated after vigorous activity and can be relieved after minimally invasive GMC release

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