Effect of change in patellofemoral joint contact area by the decrease in vastus medialis muscle activation on joint stress

Tomoya, Takabayashi; Mutsuaki, Edama; Takuma, Inai; Masayoshi, Kubo

doi:10.37190/abb-02234-2023-02

Abstract

Purpose: Patellofemoral pain syndrome is a common orthopedic trauma among runners. It is unclear whether patellofemoral joint stress (PFJS) is the highest (or lowest) when the knee joint flexion angle and extension moment are in combination under the condition that vastus medialis (VM) activation decreases. This study aimed to investigate the effects of changes in the PFJ contact area by decreasing the activation of the VM muscle on PFJS.

Methods: A PFJ sagittal model was used to quantify PFJ reaction force and PFJS. The PFJ model and mathematical modelling procedure were used to quantify PFJS based on previous studies. The simulation ranges were set to knee joint flexion angles of 10–45° and extension moments of 0–240 Nm. PFJS was calculated for the normal condition (NC) and decrease condition (DC) in VM activation.

Results: When the knee joint angle and knee joint moment were at the maximum, the PFJS showed the maximum value under both conditions (NC; 14.9 N/cm², DC; 16.4 N/cm²). PFJS was found to be higher in DC than that in NC for all simulation ranges.

Conclusion: Decreased VM activation may be involved in the mechanism of patellofemoral pain syndrome. In addition, the results of this study provide evidence that clinicians can enhance VM to relieve pain in patients with patellofemoral pain syndrome.

References

Aminaka N., Gribble P.A., Patellar taping, patellofemoral pain syndrome, lower extremity kinematics, and dynamic postural control, J. Athl. Train., 2008, 43 (1), 21–28, DOI: 10.4085/1062-6050-43.1.21.
Search in Google Scholar Back to article
Amis A.A., Firer P., Mountney J., Senavongse W., Thomas N.P., Anatomy and biomechanics of the medial patellofemoral ligament, Knee, 2003, 10 (3), 215–220, DOI: 10.1016/s0968-0160(03)00006-1.
Search in Google Scholar Back to article
Besier T.F., Fredericson M., Gold G.E., Beaupre G.S., Delp S.L., Knee muscle forces during walking and running in patellofemoral pain patients and pain-free controls, J. Biomech., 2009, 42 (7), 898–905, DOI: 10.1016/j.jbiomech.2009.01.032.
Search in Google Scholar Back to article
Bonacci J., Hall M., Fox A., Saunders N., Shipsides T., Vicenzino B., The influence of cadence and shoes on patellofemoral joint kinetics in runners with patellofemoral pain, Journal of Science and Medicine in Sport, 2018, 21 (6), 574–578, DOI: 10.1016/j.jsams.2017.09.593.
Search in Google Scholar Back to article
Bonacci J., Vicenzino B., Spratford W., Collins P., Take your shoes off to reduce patellofemoral joint stress during running, Br. J. Sports Med., 2014, 48 (6), 425–428, DOI: 10.1136/bjsports-2013-092160.
Search in Google Scholar Back to article
Cowan S.M., Crossley K.M., Bennell K.L., Altered hip and trunk muscle function in individuals with patellofemoral pain, Br. J. Sports Med., 2009, 43 (8), 584–588, DOI: 10.1136/bjsm.2008.053553.
Search in Google Scholar Back to article
Crossley K.M., Is patellofemoral osteoarthritis a common sequela of patellofemoral pain?, Br. J. Sports Med., 2014, 48 (6), 409–410, 10.1136/bjsports-2014-093445.
Search in Google Scholar Back to article
Csintalan R.P., Schulz M.M., Woo J., McMahon P.J., Lee T.Q., Gender differences in patellofemoral joint biomechanics, Clin. Orthop. Relat. Res., 2002 (402), 260–269.
Search in Google Scholar Back to article
Duffey M.J., Martin D.F., Cannon D.W., Craven T., Messier S.P., Etiologic factors associated with anterior knee pain in distance runners, Med. Sci. Sports Exerc., 2000, 32 (11), 1825–1832, DOI: 10.1097/00005768-200011000-00003.
Search in Google Scholar Back to article
Farrokhi S., Keyak J.H., Powers C.M., Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: a finite element analysis study, Osteoarthritis Cartilage, 2011, 19 (3), 287–294, 10.1016/j.joca.2010.12.001.
Search in Google Scholar Back to article
Fukuchi R.K., Fukuchi C.A., Duarte M., A public dataset of running biomechanics and the effects of running speed on lower extremity kinematics and kinetics, Peer J., 2017, 5, e3298, 10.7717/peerj.3298.
Search in Google Scholar Back to article
Fulkerson J.P., Diagnosis and treatment of patients with patellofemoral pain, Am. J. Sports Med., 2002, 30 (3), 447–456, DOI: 10.1177/03635465020300032501.
Search in Google Scholar Back to article
Han S.W., Sawatsky A., Jinha A., Herzog W., Effect of vastus medialis loss on rabbit patellofemoral joint contact pressure distribution, Journal of Applied Biomechanics, 2020, 36 (6), 390–396, DOI: 10.1123/jab.2020-0056.
Search in Google Scholar Back to article
Hart H.F., Patterson B.E., Crossley K.M., Culvenor A.G., Khan M.C.M., King M.G. et al., May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions – a systematic review and meta-analysis, Br. J. Sports Med., 2022, DOI: 10.1136/bjsports-2021-104686.
Search in Google Scholar Back to article
Heino Brechter J., Powers C.M., Patellofemoral stress during walking in persons with and without patellofemoral pain, Med. Sci. Sports Exerc., 2002, 34 (10), 1582–1593, DOI: 10.1249/01.MSS.0000035990.28354.c6.
Search in Google Scholar Back to article
Lee D.C., Pate R.R., Lavie C.J., Sui X., Church T.S., Blair S.N., Leisure-time running reduces all-cause and cardiovascular mortality risk, J. Am. Coll. Cardiol., 2014, 64 (5), 472–481, DOI: 10.1016/j.jacc.2014.04.058.
Search in Google Scholar Back to article
Nunes G.S., Scattone Silva R., dos Santos A.F., Fernandes R.A.S., Serrão F.V., de Noronha M., Methods to assess patellofemoral joint stress: A systematic review, Gait and Posture, 2018, 61, 188–196, DOI: 10.1016/j.gaitpost.2017.12.018.
Search in Google Scholar Back to article
Pal S., Besier T.F., Draper C.E., Fredericson M., Gold G.E., Beaupre G.S. et al., Patellar tilt correlates with vastus lateralis: vastus medialis activation ratio in maltracking patellofemoral pain patients, J. Orthop. Res., 2012, 30 (6), 927–933, DOI: 10.1002/jor.22008.
Search in Google Scholar Back to article
Pal S., Besier T.F., Gold G.E., Fredericson M., Delp S.L., Beaupre G.S., Patellofemoral cartilage stresses are most sensitive to variations in vastus medialis muscle forces, Comput. Methods Biomech. Biomed. Engin., 2019, 22 (2), 206–216, DOI: 10.1080/10255842.2018.1544629.
Search in Google Scholar Back to article
Pal S., Draper C.E., Fredericson M., Gold G.E., Delp S.L., Beaupre G.S. et al., Patellar maltracking correlates with vastus medialis activation delay in patellofemoral pain patients, Am. J. Sports Med., 2011, 39 (3), 590–598, DOI: 10.1177/0363546510384233.
Search in Google Scholar Back to article
Powers C.M., Ward S.R., Chen Y.J., Chan L.D., Terk M.R., The effect of bracing on patellofemoral joint stress during free and fast walking, Am. J. Sports Med., 2004, 32 (1), 224–231.
Search in Google Scholar Back to article
Rudert M., Histological evaluation of osteochondral defects: consideration of animal models with emphasis on the rabbit, experimental setup, follow-up and applied methods, Cells Tissues Organs, 2002, 171 (4), 229–240, DOI: 10.1159/000063125.
Search in Google Scholar Back to article
Sawatsky A., Bourne D., Horisberger M., Jinha A., Herzog W., Changes in patellofemoral joint contact pressures caused by vastus medialis muscle weakness, Clinical Biomechanics, 2012, 27 (6), 595–601, https://doi.org/10.1016/j.clinbiomech.2011.12.011
Search in Google Scholar Back to article
Shen A., Boden B.P., Grant C., Carlson V.R., Alter K.E., Sheehan F.T., Adolescents and adults with patellofemoral pain exhibit distinct patellar maltracking patterns, Clinical Biomechanics, 2021, 90, DOI: 10.1016/j.clinbiomech.2021.105481.
Search in Google Scholar Back to article
Takabayashi T., Edama M., Inai T., Tokunaga Y., Kubo M., Influence of sex and knee joint rotation on patellofemoral joint stress, Acta Bioeng. Biomech., 2022, 24 (3), 161–168, 10.37190/ABB-02115-2022-03.
Search in Google Scholar Back to article
Taunton J.E., Ryan M.B., Clement D.B., McKenzie D.C., Lloyd-Smith D.R., Zumbo B.D., A retrospective casecontrol analysis of 2002 running injuries, Br. J. Sports Med., 2002, 36 (2), 95–101
Search in Google Scholar Back to article
Thomas M.J., Wood L., Selfe J., Peat G., Anterior knee pain in younger adults as a precursor to subsequent patellofemoral osteoarthritis: a systematic review, BMC Musculoskelet. Disord., 2010, 11, 201, DOI: 10.1186/1471-2474-11-201.
Search in Google Scholar Back to article
Tomoya T., Mutsuaki E., Takuma I., Yuta T., Masayoshi K., A mathematical modelling study investigating the influence of knee joint flexion angle and extension moment on patellofemoral joint reaction force and stress, Knee, 2019, 26 (6), 1323–1329, DOI: 10.1016/j.knee.2019.10.010.
Search in Google Scholar Back to article
Van Eijden T.M., Kouwenhoven E., Verburg J., Weijs W.A., A mathematical model of the patellofemoral joint, J. Biomech., 1986, 19 (3), 219–229
Search in Google Scholar Back to article
Waiteman M.C., Briani R.V., Pazzinatto M.F., Ferreira A.S., Ferrari D., de Oliveira Silva D. et al., Relationship between knee abduction moment with patellofemoral joint reaction force, stress and self-reported pain during stair descent in women with patellofemoral pain, Clin. Biomech. (Bristol, Avon), 2018, 59, 110–116, DOI: 10.1016/j.clinbiomech.2018.09.012.
Search in Google Scholar Back to article
Whyte E.F., Moran K., Shortt C.P., Marshall B., The influence of reduced hamstring length on patellofemoral joint stress during squatting in healthy male adults, Gait and Posture, 2010, 31 (1), 47–51, https://doi.org/10.1016/j.gaitpost.2009.08.243
Search in Google Scholar Back to article
Wickiewicz T.L., Roy R.R., Powell P.L., Edgerton V.R., Muscle architecture of the human lower limb, Clin. Orthop. Relat. Res., 1983 (179), 275–283.
Search in Google Scholar Back to article
Wilson N.A., Press J.M., Koh J.L., Hendrix R.W., Zhang L.Q., In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain, J. Bone Joint Surg. Am., 2009, 91 (3), 558–566, DOI: 10.2106/jbjs.g.00572.
Search in Google Scholar Back to article

Effect of change in patellofemoral joint contact area by the decrease in vastus medialis muscle activation on joint stress

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