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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2011

01-07-2011 | Knee

The effect of different quadriceps loading patterns on tibiofemoral joint kinematics and patellofemoral contact pressure during simulated partial weight-bearing knee flexion

Authors: Markus Wünschel, Ulf Leichtle, Christian Obloh, Nikolaus Wülker, Otto Müller

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2011

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Abstract

Purpose

The purpose of this in vitro study was to investigate the influence of different quadriceps loading patterns on tibiofemoral joint kinematics and patellofemoral pressure.

Methods

A dynamic muscle-loaded knee squat was simulated on eight knee specimens with an upright knee simulator while measuring tibiofemoral joint kinematics and patellofemoral pressure distribution. The quadriceps muscle was attached to three actuators simulating the three main extensor muscles, and five different quadriceps loading patterns were tested.

Results

Tibial axial and varus-valgus-rotation are affected most while changing quadriceps loading patterns from lateral to medial. Higher internal tibial rotation is associated with higher medial muscle load compared to the symmetrical loading condition. Contact force, contact area and maximum peak pressure rise with increasing flexion angles. Accentuating the vastus lateralis muscle induces a significant reduction in patellofemoral contact force and a 30% diminished contact area at 90° of flexion.

Conclusion

Strengthening the vastus medialis muscle leads to increased internal tibial rotation, thus optimizing patella tracking by lowering the Q-angle. In contrast, weakness of the vastus medialis muscle causes decreased tibial internal rotation and is associated with lower patellofemoral contact pressure and contact area. Vastus medialis exercise is advisable to improve patella tracking but may not be recommended in patients with disorders due to increased patellofemoral contact pressure.
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Metadata
Title
The effect of different quadriceps loading patterns on tibiofemoral joint kinematics and patellofemoral contact pressure during simulated partial weight-bearing knee flexion
Authors
Markus Wünschel
Ulf Leichtle
Christian Obloh
Nikolaus Wülker
Otto Müller
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-010-1359-y

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