Abstract
Patellofemoral pain syndrome has a high morbidity, and its pathology is closely associated with patellofemoral joint kinematics. A series of in vivo and in vitro studies have been conducted to explore patellofemoral kinematics, and the findings are relevant to the diagnosis, classification, and management of patellofemoral diseases and even the whole knee joint. However, no definite conclusion on normal patellofemoral kinematics has been established. In this study, the measurement methodologies of patellofemoral kinematics (including data collection methods, loading conditions, and coordinate system) as well as their advantages and limitations were reviewed. Motion characteristics of the patella were analyzed. During knee flexion, the patellar flexion angle lagged by 30–40% compared to the tibiofemoral joint flexion. The patella tilts, rotates, and shifts medially in the initial stage of knee flexion and subsequently tilts, rotates, and shifts laterally. The finite patellar helical axis fluctuates near the femoral transepicondylar axis or posterior condylar axis. Moreover, factors affecting kinematics, such as morphology of the trochlear groove, soft tissue balance, and tibiofemoral motion, were analyzed. At the initial period of flexion, soft tissues play a vital role in adjusting patellar tracking, and during further flexion, the status of the patella is determined by the morphology of the trochlear groove and patellar facet. Our findings could increase our understanding of patellofemoral kinematics and can help to guide the operation plan for patients with patellofemoral pain syndrome.
Highlights
Patellofemoral pain syndrome (PFPS) is associated with a high morbidity 13–20% [1,2,3,4] and a prevalence of up to 40% among athletes [5]
A number of studies have shown a significant correlation between PFPS and several factors, including reduced strength of the quadriceps and reduced Q-angle, patellofemoral malalignment, dysplasia of the femoral trochlea, and patellofemoral disorders [7,8,9,10,11]
Based on data from ten studies, we found that the patellar rotation angle was confined to the range from −1° to 2° within 30° of knee flexion [15, 30,31,32, 38,39,40,41,42, 44]
Summary
Patellofemoral pain syndrome (PFPS) is associated with a high morbidity 13–20% [1,2,3,4] and a prevalence of up to 40% among athletes [5]. A number of studies have shown a significant correlation between PFPS and several factors, including reduced strength of the quadriceps and reduced Q-angle, patellofemoral malalignment, dysplasia of the femoral trochlea, and patellofemoral disorders [7,8,9,10,11]. Many researchers have undertaken in vivo and in vitro studies to clarify patellofemoral joint kinematics and their association with diseases, with a view to providing evidence necessary for determining a standard therapeutic regimen. In this study, different measurement methodologies were reviewed, which could affect the description of patellar tracking. We identified the bottlenecks in patellofemoral kinematics research and proposed a methodology for further studies
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