Patello-femoral tracking in the weight-bearing knee: a study of asymptomatic volunteers utilising dynamic magnetic resonance imaging: a preliminary report
PainSci summary of Tennant 2001?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.
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,” an article in Manual Therapy, 2009.
- “Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome,” an article in Journal of Bone & Joint Surgery, 2006.
- “Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function,” an article in Rev Bras Ortop, 2016.
- “Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: An upright, weightbearing MRI study,” an article in Journal of Orthopaedic Research, 2013.
- “Associates of physical function and pain in patients with patellofemoral pain syndrome,” an article in Archives of Physical Medicine & Rehabilitation, 2009.
- “The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome,” an article in Physical Therapy in Sport, 2011.
These two articles on PainScience.com cite Tennant 2001 as a source:
- PS Save Yourself from Patellofemoral Pain Syndrome! — Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
- PS Patellofemoral Tracking Syndrome — The beating heart of the conventional wisdom about patellofemoral pain is mostly nonsense
