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The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions

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) scanne...

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Autores principales: Yang, Jae-suk, Fredericson, Michael, Choi, Jang-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526904/
https://www.ncbi.nlm.nih.gov/pubmed/32997727
http://dx.doi.org/10.1371/journal.pone.0239907
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author Yang, Jae-suk
Fredericson, Michael
Choi, Jang-Hwan
author_facet Yang, Jae-suk
Fredericson, Michael
Choi, Jang-Hwan
author_sort Yang, Jae-suk
collection PubMed
description 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 (PT(x), mm), patellar proximal-distal shift (PT(y), mm), and patellar anterior-posterior shift (PT(z), mm). Tests for statistical significance (p < 0.05) showed that the PF during WB30°, the PT(y) during NWB0°, and the PT(z) 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 PT(z) 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.
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spelling pubmed-75269042020-10-06 The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions Yang, Jae-suk Fredericson, Michael Choi, Jang-Hwan PLoS One Research Article 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 (PT(x), mm), patellar proximal-distal shift (PT(y), mm), and patellar anterior-posterior shift (PT(z), mm). Tests for statistical significance (p < 0.05) showed that the PF during WB30°, the PT(y) during NWB0°, and the PT(z) 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 PT(z) 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. Public Library of Science 2020-09-30 /pmc/articles/PMC7526904/ /pubmed/32997727 http://dx.doi.org/10.1371/journal.pone.0239907 Text en © 2020 Yang et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yang, Jae-suk
Fredericson, Michael
Choi, Jang-Hwan
The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title_full The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title_fullStr The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title_full_unstemmed The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title_short The effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
title_sort effect of patellofemoral pain syndrome on patellofemoral joint kinematics under upright weight-bearing conditions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526904/
https://www.ncbi.nlm.nih.gov/pubmed/32997727
http://dx.doi.org/10.1371/journal.pone.0239907
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