2015 ISAKOS Biennial Congress ePoster #1916
Lower Extremity Rotational Profile and Parameters of Patellofemoral Alignment in Patients with Chronic Unilateral Anterior Knee Pain- A CT Study
Murat Altintas, MD, Balikesir TURKEY
Ahmet Bayar, Assoc Prof., Zonguldak TURKEY
Egemen Turhan, MD, Prof., Ankara, Capital TURKEY
Selçuk Keser, MD, ZONGULDAK TURKEY
Ahmet Ege, Prof., MD, ZONGULDAK TURKEY
Murat Songür, YRD.DOÇ.DR., ZONGULDAK TURKEY
Bulent Ecevit University Faculty of Medicine Department of Orthopaedics and Traumatology, Zonguldak, TURKEY
FDA Status Cleared
Summary: Patients with unilateral chronic anterior knee pain not only have different rotational profile than controls, but also dispay different patellofemoral alignment characteristics than their contralateral asymptomatic knees.
LOWER EXTREMITY ROTATIONAL PROFILE AND PARAMETERS OF PATELLOFEMORAL ALIGNMENT IN PATIENTS WITH CHRONIC UNILATERAL ANTERIOR KNEE PAIN-A CT STUDY
The aim of this study was to evaluate the effects of structural factors that would have a role in etiology of anterior knee pain and various patellofemoral (PF) alignment parameters related to this clinical entity, in a group of patients with chronic unilateral anterior knee pain.
Thirtyfive patients suffering from unilateral anterior knee pain for more than 6 months were included and their problematic knees constituted the patient group (I), while their contralateral asymptomatic knees formed group II. On the other hand 40 volunteers without any history of knee pain or pathology were also taken, of whom unilateral extremities were included after being chosen via randomisation, to make up group III. Patients with PF arthritis, meniscal pathology, bilateral anterior knee pain, patellar dislocation, history of metabolic, inflammatory or neurologic diseases and those below the age of 20 and over 40 were excluded. None of the patients in Group I had undergone surgical intervention for his/her PF pain.
Group I consisted of 16 male and 19 female patients, with a mean age of 30.8 years and a BMI of 22.8. Sex distribution, mean age and BMI was similar in group III. Patients were suffering from PF pain for a mean of 35.8 months with a mean VAS of 5.8.
All subjects were first examined and Q angles were measured. Then lower extremities were imaged with low dose CT to measure femoral anteversion, tibial torsion, sulcus angle (in 0° and 30° knee flexion) and lateral patellar tilt angle and lateral patellar displacement (in 0°, 0° with quadriceps contraction and 30° flexion).
There were no significant differences between group I and II in terms of mean Q angle, femoral anteversion and tibial torsion, whereas these differences were significant between group I and III. Mean sulcus angles in both 0° and 30° measurements were significantly higher in Group I compared to group II. The difference between group I and III was significant only in 30° measurements. Mean patellar tilt angles in both 0° and 0° with quadriceps contraction measurements were significantly higher in group I compared to group II. Patellar tilt was higher in group I in comparison to group III only in 0° with quadriceps contraction. There was significant difference between group I and II in terms of lateral patellar displacement only in 0°, while the displacement was significantly higher in group I compared to group III in 0° and 0° with quadriceps contraction.
We also found that mean sulcus angle of group I in 30° degrees was 15.9° lower compared to 0° measurements. Also the tilt angle was 3.2° lower and lateral displacement was 1.9 mm lesser.
This study showed that patients with anterior knee pain have a tendency for increased femoral anteversion and tibial torsion. The patients with unilateral symptoms display differences between sides in terms of some PF alignment parameters in spite of similar rotational profiles.