Patello-femoral tracking in the weight-bearing knee: a study of asymptomatic volunteers utilising dynamic magnetic resonance imaging: a preliminary report
Two articles on PainSci cite Tennant 2001: 1. The Complete Guide to Patellofemoral Pain Syndrome 2. Patellofemoral Tracking Syndrome
PainSci notes on Tennant 2001:
From the abstract: “These results indicate that mild lateral tilting and displacement can be normal phenomena in the weight-bearing knee in early flexion and should not necessarily be taken as evidence of abnormal tracking in symptomatic patients.”
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Normal patello-femoral tracking is not well defined, and conventional radiological techniques do not allow imaging in the physiological, weight-bearing stance. A vertical-access open configuration magnetic resonance scanner allows imaging of patello-femoral tracking during weight-bearing and through a wide range of knee flexion. We imaged 40 asymptomatic knees in this way, producing axial scans which were analysed qualitatively and quantitatively using sulcus angle, congruence angle, lateral patello-femoral angle and patellar centralisation, to assess patellar tilt and displacement. Mild lateral tilting in hyperextension with the quadriceps relaxed was seen, but quantitative assessment of this was impeded by internal rotation of the femur in extension. One-half of the knees were slightly laterally displaced in hyper-extension, becoming central during the first 30 degrees of knee flexion. During passive flexion of the knee in a seated position, fewer knees were laterally tilted or displaced, and no consistent change was seen during flexion. These results indicate that mild lateral tilting and displacement can be normal phenomena in the weight-bearing knee in early flexion and should not necessarily be taken as evidence of abnormal tracking in symptomatic patients. Lateral to medial movement of the patella occurs during normal knee flexion. In addition, imaging in the weight-bearing knee can provide valuable information not gained by imaging during passive knee flexion.
related content
- “The reliability and validity of assessing medio-lateral patellar position: a systematic review,” Toby O Smith, Leigh Davies, and Simon T Donell, Manual Therapy, 2009.
- “Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome,” N J MacIntyre, N A Hill, R A Fellows, R E Ellis, and D R Wilson, Journal of Bone & Joint Surgery, 2006.
- “Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function,” Gabriel Peixoto Leão Almeida, Ana Paula de Moura Campos Carvalho E Silva, Fábio Jorge Renovato França, Maurício Oliveira Magalhães, Thomaz Nogueira Burke, and Amélia Pasqual Marques, Rev Bras Ortop, 2016.
- “Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: An upright, weightbearing MRI study,” Saikat Pal, Thor F Besier, Gary S Beaupre, Michael Fredericson, Scott L Delp, and Garry E Gold, Journal of Orthopaedic Research, 2013.
- “Associates of physical function and pain in patients with patellofemoral pain syndrome,” Sara R Piva, G Kelley Fitzgerald, James J Irrgang, Julie M Fritz, Stephen Wisniewski, Gerald T McGinty, John D Childs, Manuel A Domenech, Scott Jones, and Anthony Delitto, Archives of Physical Medicine & Rehabilitation, 2009.
- “The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome,” Chen-Yi Song, Jiu-Jenq Lin, Mei-Hwa Jan, and Yeong-Fwu Lin, Physical Therapy in Sport, 2011.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.
- Sudden amnesia resulting in pain relief: the relationship between memory and pain. Choi 2007 Pain.
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.