|Group 4 | |Patellofemoral Dysfunction | |Sports Injuries I |
| | |Amber Vincioni | |Ben Willy | |Michelle Donnell | |Valerie Salazar | | | |4/28/2010 | Introduction
Patellofemoral dysfunction affects 25 % of the general population.3 The most common etiology is abnormal patellar tracking or patellar alignment. Causes can be from biomechanical abnormalities of the lower extremity, acute or chronic injuries to the knee joint and/or weak knee joint musculature. It is important for the mechanism of this dysfunction to be identified and treated so a specific rehabilitation program can be prescribed. Mechanism of Injury
The first mechanism, which seems to be the most detrimental, is the affects of Tibiofemoral Osteoarthritis (TF OA) and Patellofemoral Osteoarthritis (PF OA). In both cases of OA, a few signs and symptoms would be grinding, pain with extension and flexion of the knee and stiffness. These signs and symptoms may also be a product of overuse. According to Hunter, Zhang, Niu, Felson, Kwoh and Newman the causes of TF OA and PF OA have different epidemiology on the knee, but have little evidence to show why exactly it hinders the joints so severely as the OA progresses. They go on to say that the compartments affected by the diseases respond differently and therefore have different affects on the mechanics of that joint. “First, the designs of the PF and TF compartments each reflect unique functions and mechanics (13). Second, subjects with knee OA may have disease isolated to the PF compartment, isolated to one TF compartment, or concomitant disease in the PF compartment and one TF compartment (8). In individuals with PF OA and TF OA in the same knee, no correlation has been found between OA severity in the PF and TF compartments (14).” Where TF OA and PF OA are chronic injuries to the patellofemoral joint, some injuries are acute, such as dislocations that can potentially lead to future subluxations causing more damage to the joint. “Traumatic patellar dislocations affect mainly adolescents and young adults. Up to 44% of patients will develop recurrent dislocation” (Lim, Chang, Hui 2008). Many dislocations occur due to a blunt force to the knee. When the patella is dislocated, it may sit inferior, superior, medially or laterally to the tibiofemoral joint. Patellar tendon tears should also be taken into consideration when evaluating the injury since it is commonly seen with dislocations. Since subluxations are mostly caused by dislocations, surgical intervention is sometimes needed to correct it unless aggressive muscle strengthening is introduced. Biomechanics is another mechanism that should be looked at when dealing with someone who has chronic PFJ pain. In this brief excerpt from the Bulletin of the NYU Hospital for Joint Diseases by BJ White and OH Sherman the Q-angle, bony anatomy abnormalities and weak VMO is discussed. “Many investigators have questioned whether a “normal”...
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