Patellofemoral Joint

FIGURE 49.13 Calculated rolling/gliding ratio for the patellofemoral joint as a function of the knee flexion angle. (From van Eijden T.M.G.J., Kouwenhoven E., Verburg J. et al. /. Biomech. 19 226.)... 

Farahmand R, Senavongse W., and Amis A.A. 1998. Quantitative study of the quadriceps muscles and trochlear groove geometry related to instability of the patellofemoral joint. /. Orthop. Res. 16 136. 

Goodfellow J., Hungerford D.S., and Zindel M. 1976. Patellofemoral joint mechanics and pathology. /. Bone Joint Surg. 58B 287. 

Powers, C.M. et al, The effect of bracing on patellofemoral joint stress during free and fast walking. Am. J. Sports Med., 32,224,2004. 

The conclusions of this study are that, in anatomic double-bundle ACL reconstruction, anterior stability was improved and there were no harmful effects on patellofemoral joint findings by 2-mm notchplasty however, notchplasty likely caused over-constrained knees, leading to a need for additional synovectomy in some cases. On the other hand, anatomic double-bundle ACL reconstmction without notchplasty did not increase the incidence of loss of extension and graft failure. Therefore, except in cases with spur formation on the intercondylar notch or narrow notch, routine notchplasty is not recommended in anatomic double-bundle ACL reconstmction. 

Wang SF, Cheng HC et al. (1999) Fat-suppressed three-dimensional fast spoiled gradient-recalled echo imaging a modified FS 3D SPGR technique for assessment of patellofemoral joint chondromalacia. Clin Imaging 23 177-180... 

The quadriceps muscle attaches to the patella via the quadriceps tendon and the retinaculum medially and laterally. They are attached to the tibial tuberosity distally via the patella tendon. They are therefore integral to the stability of the patellofemoral joint. 

During walking, the tibiofemoral joint has 2-4 times the body weight across it, whereas the patellofemoral joint has only 0.5 times body weight. 

Traumatic acute patellofemoral joint dislocation is uncommon in children. The patella almost always dislocates laterally. Certain anatomical variants predispose to dislocation. These include patella alta, trochlea dysplasia and genu valgum. 

Conclusion Ablation of the VM did not cause a lateral shift in patellar tracking, or an increase in lateral pressure distribution in the patellofemoral joint, as has been suggested clinically and anecdotally. It is not known whether this result would also hold for the human knee, but it does raise the question why clinical treatments of patellofemoral joint pain are concerned primarily with strengthening VM, despite a lack of direct evidence that VM strengthening will alter patellar tracking and/or patellofemoral contact pressure distributions. 

Cohen Z, Henry J, McCarthy D, Mow V, Ateshian G (2003) Computer simulations of patellofemoral joint surgery. The American Journal of Sports Medicine 31 87. 

The patellofemoral joint is formed by the groove of the femoral trochlea and the V-shaped articular facet of the patella (Fig. 14.2a). The orientation of the articular surfaces of these bones varies from... 

Activity Reference Patellofemoral Joint Tibiofemoral Joint (compression) Tibiofemoral Joint (anterior shear) ... 

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