Abstract
There is limited understanding of how patella realignment or patellectomy to surgically manage patellofemoral pain (PFP) affects knee biomechanics. By analysing marsupials like kangaroos that lack an ossified patella, actionable biomimetic insight for the management of end-stage PFP could be gained. This study aimed to provide the foundation of a multi-stage approach, by establishing a static biomechanical profile of the kangaroo stifle that informs the inputs and factors requiring consideration for future dynamic analyses. Volumetric CT and MRI sequences were obtained for four hindlimbs from two Macropus giganteus specimens, from which three-dimensional models of the stifles were created. Two limbs were dissected to visualise the insertion points, origins and lines of action of the quadriceps muscles and the knee extensor mechanism. Static measurements were obtained from the three-dimensional models to establish the biomechanical profile. The results confirmed structural differences in the kangaroo stifle with lack of an ossified patella, a prominent tuberosity and a shorter femur, which functionally affect the mechanical advantage and the torque-generating capability of the joint. The data reported in this study can be used to inform the inputs and constraints of future comparative analyses from which important lessons can be learned for the human knee.
Highlights
Patellofemoral pain (PFP) is one of the most prevalent knee disorders and is associated with pain and functional limitations in affected patients, who report a reduced quality of life [1,2]
The data reported in this study can be used to inform the inputs and constraints of future comparative analyses from which important lessons can be learned for the human knee
Growing evidence suggests that PFP lies on a continuum with patellofemoral (PF) osteoarthritis (OA), and is driven by factors such as altered biomechanics, tissue homeostasis, and non-mechanical changes in the PF joint [3]
Summary
Patellofemoral pain (PFP) is one of the most prevalent knee disorders and is associated with pain and functional limitations in affected patients, who report a reduced quality of life [1,2]. Patellectomies (total or partial) are uncommon and are reserved as a salvage procedure for severe fractures or more advanced cases of OA, infections and tumoral conditions [7]. They significantly affect the biomechanics of the knee extensor mechanism, resulting in ligament instability, reduced muscle strength and loss of range of motion [8,9]. Tensioning of the knee extensor mechanism, to compensate for the reduced lever arm of an absent patella, has been reported with good outcomes
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