• Korean Journal of Applied Biomechanics
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• v.21 no.1
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• pp.107-114
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• 2011

Closed kinematic chain exercises such as squatting have been widely indicated for knee rehabilitation in patients with patellofemoral disorders such as osteoarthritis and patellofemoral pain. Patellofemoral disorders are thought to be associated with abnormal patellar kinematics. In addition, the Q-angle may be undervalued in patients with patellofemoral pain and a laterally displaced patella. The purpose of this study was to assess patellar kinematics and the Q-angle during double-leg semi-squat and wall-slide semi-squat exercises. In this study, 28 asymptomatic subjects(16 male, 12 female) were assessed. Patellar tilt, patellar spin, and Q-angle were recorded using a motion analysis system during double-leg semi-squat and wall-slide semi-squat exercises. The Q-angle and patellar tilt were significantly increased, whereas patellar spin was significantly decreased, at $45^{\circ}$ of knee flexion compared with $0^{\circ}$. No differences were observed for the Q-angle, patellar tilt, and patellar spin during double-leg semi-squat and wall-slide semi-squat exercises. However, a significant interaction was observed between squat type and knee angle for patellar spin. We found that the patella is laterally tilted during semi-squat exercises and that there was no difference in patellar tracking between knee flexion during double-leg semi-squat and wall-slide semi-squat exercises.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.61-69
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• 2006

Purpose: Open lateral release and complete lateral release have been conducted as a surgical method in patients with patellofemoral malalignment. But authors sought to find out the best method by conducting selective release, with minimal excision of the involved lesion, and comparative analyzing the result, as postoperative satisfaction and complication. Materials and Methods: Over the 68 patients of 90 cases who underwent arthroscopic release, among 94 patients of 129 cases who underwent lateral retinacular release, from January 1993 to June 1998 were followed up prospectively. A radiological evaluation of patellar inclination, patellar tilt, congruence angle, and Q-angle and a clinical evaluation of HSS-Knee score and modified patellar score were used for analysis data before operation and data at 1 year and 5 year after operation. Results: According to the radiologic evaluation, the patellar tilt and translation revealed improvement of the results, from $13.4^{\circ}$ and 12.1mm to $3.6^{\circ}$ and 3.8mm with arthroscopic lateral complete release, and from $12.3^{\circ}$ and 11.2mm to $4.8^{\circ}$ and 5.2mm with selective release, and from $13.6^{\circ}$ and 12.3mm to $3.3^{\circ}$ and 3mm with open release. But they were not significantly related to the clinical results. HSS-Knee score was 84.2%(48/57), 81.8%(27/33), 82.1%(32/39) and modified patellar score was 82.5%(47/57), 81.8%(27/33), 82.1%(32/39) respectively, which revealed satisfactory results. And no significant difference among the operative methods were shown. Conclusion: Arthroscopic lateral retinacular release which is one of the surgical method for patellofemoral malalignment enhances rehabilitation and satisfaction of the patient, by releasing the involved retinaculum within lesser surgical extent, compared to open and complete lateral release without complications such as adhesion.

• Journal of Veterinary Clinics
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• v.34 no.5
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• pp.318-324
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• 2017

The objective of this study was to establish kinematic reference ranges for the femorotibial (FT) joint and the patellofemoral (PF) joint in healthy small-breed dogs by measuring 3D kinematics at the walk. Single-plane fluoroscopy was used to image the stifle joints of five healthy beagle dogs while the dogs were walking. 3D bone models of the femur, patella, and tibia were reconstructed by computed tomography scanning of the beagle dogs' hind limbs. The shape-matching technique was used to measure kinematic data from the fluoroscopic images and the 3D bone models. The cranial translation of the tibia during walking was inversely proportional to the FT joint flexion. There were significant correlations between the patellar motion and the tibial motion. The FT joint flexion had a strong correlation with the patellar proximodistal translation and flexion. Additionally, the tibial mediolateral translation had a strong correlation with the patellar shift and tilt. In this study, normal in vivo 3D FT joint and PF joint kinematics were demonstrated, and the average kinematic parameters were determined in walking beagle dogs.

• Physical Therapy Korea
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• v.26 no.1
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• pp.75-83
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• 2019

Background: A tight iliotibial band (ITB) may lead to lateral patellar maltracking, compression, and tilt, and dominant vatus lateralis (VL) muscle activation relative to vastus medialis oblique (VMO) can laterally displace the patella, which leads to anterior knee pain. Therefore, an effective management technique is needed to stabilize the patella in individuals with tight ITB. Increased stability during the modified Thomas test has the potential to decrease compensatory motion and thus to selectively stretch the ITB. Objects: The purpose of this study was to determine the effects of ITB stretching in the modified Thomas test position on ITB flexibility, patellar translation, and muscle activities of the VMO and VL during quadreceps-setting (QS) exercise in individuals with tight ITB. Methods: Twenty-one subjects with tight ITB were recruited. Digital inclinometer was used to measure the hip adduction angle during the modified Ober test. Universal goniometer was used to measure the hip abduction angle during the modified Thomas test. Ultrasonography was used to measure the patella-condylar distance. Electromyography was performed to collect data of muscle activities. Paired t-test was used to determine the statistical significance between pretest and posttest. Results: The range of hip adduction in modified Ober test increased (p=.04) and the range of hip abduction in the modified Thomas test decreased after ITB stretching (p<.01). There was no difference between lateral patellar translation (p=.18). VMO muscle activity significantly increased after ITB stretching during QS (p<.01). VL muscle activity had no difference after stretching. Conclusion: The ITB stretching in the modified Thomas test position can be suggested as a management method for improving ITB flexibility and VMO muscle activity in individuals with tight ITB.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.214-218
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• 2006

Purpose: We describe a new technique of arthroscopic medial plication using pull-out suture with consideration of anatomical location of medial patellofemoral ligament for the treatment of acute or recurrent patellar dislocation. Operative technique: Under arthroscopic examination, sutures are passed through the medial capsule, at which medial patellofemoral ligament is located, from outside to inside of knee joint. Three guide wires are inserted from anterior surface of the patella to upper half of its medial border. Intraarticular portions of sutures are pulled out toward anterior surface of the patella through bony tunnels. Under appropriate tension, the sutures are tied after performing lateral retinacular release. Conclusion: As suturing medial patellofemoral ligament, this technique can maximize the effect of medial plication and can correct subluxation and tilt of the patella. It seems to be a minimally invasive, easy and effective method for the treatment of acute or recurrent patellar dislocation.