Background: Patellofemoral joint kinematics is a complex three-dimensional(3D) motion, involving shift and rotation in the coronal, sagittal, and axial directions. Quantifying patellar tracking only at the axial level of the patella or with two-dimensional(2D) parameters may not be comprehensive. The current study sought to explore the spatial kinematics characteristics of the patella in three directions, especially the sagittal plane in patients with patellofemoral pain (PFP) based on Four-dimensional computed tomography (4D-CT).
Methods: A total of 35 knees with PFP and 35 controls from March 2023 to May 2024 were evaluated. 3D shift and tilt of the patella were measured in the patellofemoral joint coordinate system established by MIMICS. The 3D shift and tilt of the patella in three directions (coronal, sagittal, and axial) were evaluated. Differences between groups were analyzed using two-way repeated measures ANOVA.
Results: The 3D tilt and 3D tilt trends differed between the two groups (P = 0.020, 0.018, respectively). The 3D shift at knee flexions of 50° to 70° was significantly increased in the PFP group compared to the control group (P = 0.009, 0.015, respectively). The 3D tilt was significantly greater in the PFP group than in the control group at -10° to 10° and 50° to 70° of knee flexion (P = 0.004, 0.005, 0.046, 0.007, respectively). The 3D tilt was significantly greater in the PFP group than in the control group at -10° to 0° and 40° to 70° of knee flexion (P = 0.033, 0.011, 0.004, 0.015, respectively). The 3D shift at knee flexions of -10° to 20° were significantly decreased in the PFP group compared to the control group (P = 0.002, < 0.001, 0.018, respectively).
Conclusion: It is necessary to evaluate the spatial position characteristics of the patellofemoral joint and the stability of the patella from multiple planes and angles at the dynamic level. Analyzing the spatial multi-plane kinematic characteristics of the patellofemoral joint may help in determining the etiology of PFP.
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| http://dx.doi.org/10.1186/s13018-025-05610-9 | DOI Listing |
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