女性髌股关节疼痛研究.pdfVIP

Patellofemoral Kinematics and Tibial Tuberosity–Trochlear Groove Distances in Female Adolescents With Patellofemoral Pain Victor R. Carlson,* BS, Barry P. Boden,yz MD, and Frances T. Sheehan,* PhD Investigation performed at the Functional and Applied Biomechanics Section, Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland, USA Background: Patellofemoral pain (PFP) is a prevalent disorder among female adolescents. Overuse is frequently cited as the cause of pain for this population. What is currently unclear, however, is if the patella demonstrates abnormal tracking patterns relative to the femoral trochlear groove in female adolescents with PFP. Purpose: The aim of this case-control study was to determine if abnormal patellar tracking patterns are present in female ado- lescents with PFP. The secondary aim was to identify if an increased tibial tuberosity–trochlear groove (TT-TG) distance is asso- ciated with the observed kinematic patterns. Study Design: Controlled laboratory study. Methods: Twenty female adolescent knees from 12 patients with PFP and 20 age-matched female knees from 13 healthy con- trols were recruited for this study. Patellofemoral kinematics (eg, lateral patellar displacement) during a repetitive knee extension- flexion maneuver was quantified by dynamic cine phase-contrast magnetic resonance imaging (MRI). Static MRI scans were used to determine the TT-TG distance. Results: Relative to the control cohort, female adolescents with PFP demonstrated significantly greater lateral displacement at 10 (3.2 mm; P \.001), 20 (2.3 mm; P \.001), and 30 (1.7 mm; P = .014) of knee flexion. A subgroup within this cohort (7 knees from 5 patients) demonstrated extreme lateral maltracking .2 SDs of the mean of the control cohort. This subgroup also dem- onstrated a greater TT-TG distance relative to the controls (D = 4.2 mm; P = .001). Conclusion: This study demonstrates abnormal lat