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Published in: Clinical Rheumatology 3/2006

01-05-2006 | Original Article

Relationship of Q angle and joint hypermobility and Q angle values in different positions

Authors: Omer Faruk Sendur, Gulcan Gurer, Tuncay Yildirim, Emine Ozturk, Ali Aydeniz

Published in: Clinical Rheumatology | Issue 3/2006

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Abstract

Patellar malalignment is the most important reason for anterior knee pain. Patellar alignment is commonly determined by the measurement of the quadriceps (Q) angle. In this study, our primary aim was to investigate the Q angle difference between healthy individuals with and without joint hypermobility. The other objectives were to compare the Q angle values, which were measured in supine and upright positions, to determine hypermobility frequency among healthy males in a certain population, and to investigate the correlation between the existent skeletal deformities and Beighton score levels. Two hundred fifty-three healthy male college students were examined for hypermobility and skeletal deformities. According to the Beighton scoring system, three groups (n=20) were formed, and Q angle measurements were performed on the 60 individuals in both supine and upright positions. In the comparison of the groups, the mean Q angle values in healthy hypermobile individuals were found to be significantly higher than that of the nonhypermobile ones (p<0.05). No statistical difference was found between Q angle values in supine and upright positions (p>0.05). The frequency of joint hypermobility (Beighton score 4 or more) was found to be 29.25% in this population. No correlation was determined between existent skeletal deformities and Beighton score values (p>0.05). In conclusion, the Q angle evaluation among healthy hypermobile individuals may have a prognostic value for probable knee pathologies that may appear in the future.
Literature
1.
go back to reference France L, Nester C (2001) Effect of errors in the identification of anatomical landmarks on the accuracy of Q angle values. Clin Biomech 16:710–713CrossRef France L, Nester C (2001) Effect of errors in the identification of anatomical landmarks on the accuracy of Q angle values. Clin Biomech 16:710–713CrossRef
2.
go back to reference Hirokawa S (1991) Three-dimensional mathematical model analysis of the patellofemoral joint. J Biomech 24:659–671CrossRefPubMed Hirokawa S (1991) Three-dimensional mathematical model analysis of the patellofemoral joint. J Biomech 24:659–671CrossRefPubMed
3.
go back to reference Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. The influence of Q angle and tendofemoral contact. J Bone Joint Surg Am 66:715–724PubMed Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. The influence of Q angle and tendofemoral contact. J Bone Joint Surg Am 66:715–724PubMed
4.
go back to reference Hughston JC (1984) Subluxation of the patella. J Bone Joint Surg Am 50:1003–1026 Hughston JC (1984) Subluxation of the patella. J Bone Joint Surg Am 50:1003–1026
5.
go back to reference Insall J (1979) Chondromalacia patellae: patellar malalignment syndrome. Orthop Clin North Am 10:117–127PubMed Insall J (1979) Chondromalacia patellae: patellar malalignment syndrome. Orthop Clin North Am 10:117–127PubMed
6.
go back to reference Merchant AC, Mercer RL, Jacobsen RH, Cool CR (1974) Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 56:1391–1396PubMed Merchant AC, Mercer RL, Jacobsen RH, Cool CR (1974) Roentgenographic analysis of patellofemoral congruence. J Bone Joint Surg Am 56:1391–1396PubMed
7.
go back to reference Hungerford DS, Barry M (1979) Biomechanics of the patellofemoral joint. Clin Orthop 144:9–15PubMed Hungerford DS, Barry M (1979) Biomechanics of the patellofemoral joint. Clin Orthop 144:9–15PubMed
8.
go back to reference Aglietti P, Buzzi R, Insall JN (1993) Disorders of the patellofemoral joint. In: Insall JN, Windsor RE, Scott WN, Kelly MA, Aglietti P (eds) Surgery of the knee, 2nd edn. Churchill Livingstone, New York pp 241–385 Aglietti P, Buzzi R, Insall JN (1993) Disorders of the patellofemoral joint. In: Insall JN, Windsor RE, Scott WN, Kelly MA, Aglietti P (eds) Surgery of the knee, 2nd edn. Churchill Livingstone, New York pp 241–385
9.
go back to reference Fulkerson JP, Shea KP (1990) Disorders of patellofemoral alignment. J Bone Joint Surg Am 72:1424–1429PubMed Fulkerson JP, Shea KP (1990) Disorders of patellofemoral alignment. J Bone Joint Surg Am 72:1424–1429PubMed
10.
go back to reference Larsson LG, Baum J, Govind S, Kollia M, Kollia GD (1993) Benefits and disadvantages of joint hypermobility among musicians. N Engl J Med 329:1079–1082CrossRefPubMed Larsson LG, Baum J, Govind S, Kollia M, Kollia GD (1993) Benefits and disadvantages of joint hypermobility among musicians. N Engl J Med 329:1079–1082CrossRefPubMed
11.
go back to reference Perrini F, Tallents RH, Katzberg RW, Riberio RJ, Kyrkanides S, Moss ME (1997) Generalized joint laxity and temporomandibular disorders. J Orofac Pain 11:215–220PubMed Perrini F, Tallents RH, Katzberg RW, Riberio RJ, Kyrkanides S, Moss ME (1997) Generalized joint laxity and temporomandibular disorders. J Orofac Pain 11:215–220PubMed
12.
go back to reference Grahame R (1999) Joint hypermobility and genetic collagen disorders: are they related? Arch Dis Child 80:188–191PubMedCrossRef Grahame R (1999) Joint hypermobility and genetic collagen disorders: are they related? Arch Dis Child 80:188–191PubMedCrossRef
13.
go back to reference Beighton P (1993) The Ehlers Danlos syndromes. In: Beighton P (ed) McKusick's heritable disorders of connective tissue, 5th edn. Mosby, St. Louis p 206 Beighton P (1993) The Ehlers Danlos syndromes. In: Beighton P (ed) McKusick's heritable disorders of connective tissue, 5th edn. Mosby, St. Louis p 206
14.
go back to reference Kraus VB, Li YJ, Martin ER, Jordan JM, Renner JB, Doherty M, Wilson AG, Moskowitz R, Hochberg M, Loeser R, Hooper M, Sundseth S (2004) Articular hypermobility is a protective factor for hand osteoarthritis. Arthritis Rheum 50:2178–2183CrossRefPubMed Kraus VB, Li YJ, Martin ER, Jordan JM, Renner JB, Doherty M, Wilson AG, Moskowitz R, Hochberg M, Loeser R, Hooper M, Sundseth S (2004) Articular hypermobility is a protective factor for hand osteoarthritis. Arthritis Rheum 50:2178–2183CrossRefPubMed
15.
go back to reference Beighton P, Gahame R, Bird H (1999) Assessment of hypermobility. In: Beighton P (ed) Hypermobility of joints, 3rd edn. Springer, Berlin Heidelberg New York pp 9–22 Beighton P, Gahame R, Bird H (1999) Assessment of hypermobility. In: Beighton P (ed) Hypermobility of joints, 3rd edn. Springer, Berlin Heidelberg New York pp 9–22
16.
go back to reference Hudson N, Fitzcharles M-A, Cohen M, Star MR, Esdaile JM (1998) The association of soft-tissue rheumatism and hypermobility. Br J Rheumatol 37:382–386CrossRefPubMed Hudson N, Fitzcharles M-A, Cohen M, Star MR, Esdaile JM (1998) The association of soft-tissue rheumatism and hypermobility. Br J Rheumatol 37:382–386CrossRefPubMed
17.
go back to reference Bulbena A, Duro JC, Porta M, Faus S, Vallescar R, Martin-Santos R (1992) Clinical assessment of hypermobility of joints: assembling criteria. J Rheumatol 19:115–122PubMed Bulbena A, Duro JC, Porta M, Faus S, Vallescar R, Martin-Santos R (1992) Clinical assessment of hypermobility of joints: assembling criteria. J Rheumatol 19:115–122PubMed
18.
go back to reference Barron DF, Cohen BA, Geraghty MT, Violand R, Rowe PC (2002) Joint hypermobility is more common in children with chronic fatigue syndrome than in healthy controls. J Pediatr 141:421–425PubMedCrossRef Barron DF, Cohen BA, Geraghty MT, Violand R, Rowe PC (2002) Joint hypermobility is more common in children with chronic fatigue syndrome than in healthy controls. J Pediatr 141:421–425PubMedCrossRef
19.
go back to reference Qvindesland A, Jonsson H (1999) Articular hypermobility in Icelandic 12-year-olds. Rheumatology 38:1014–1016CrossRefPubMed Qvindesland A, Jonsson H (1999) Articular hypermobility in Icelandic 12-year-olds. Rheumatology 38:1014–1016CrossRefPubMed
20.
go back to reference Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8:444–450CrossRefPubMed Harreby M, Nygaard B, Jessen T, Larsen E, Storr-Paulsen A, Lindahl A, Fisker I, Laegaard E (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8:444–450CrossRefPubMed
21.
go back to reference El-Garf AK, Mahmoud GA, Mahgoub EH (1998) Hypermobility among Egyptian children: prevalence and features. J Rheumatol 25:1003–1005PubMed El-Garf AK, Mahmoud GA, Mahgoub EH (1998) Hypermobility among Egyptian children: prevalence and features. J Rheumatol 25:1003–1005PubMed
22.
go back to reference Rikken-Bultman DG, Wellink L, van Dongen PW (1997) Hypermobility in two Dutch school populations. Eur J Obstet Gynecol Reprod Biol 73:189–192CrossRefPubMed Rikken-Bultman DG, Wellink L, van Dongen PW (1997) Hypermobility in two Dutch school populations. Eur J Obstet Gynecol Reprod Biol 73:189–192CrossRefPubMed
23.
go back to reference Subramanyam V, Janaki KV (1996) Joint hypermobility in south Indian children. Indian Pediatr 33:771–772PubMed Subramanyam V, Janaki KV (1996) Joint hypermobility in south Indian children. Indian Pediatr 33:771–772PubMed
24.
go back to reference Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T (1985) Joint mobility among university students in Iraq. Br J Rheumatol 24:326–331PubMedCrossRef Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T (1985) Joint mobility among university students in Iraq. Br J Rheumatol 24:326–331PubMedCrossRef
25.
go back to reference Birrell FN, Adebajo AO, Hazleman BL, Silman AJ (1994) High prevalence of joint laxity in West Africans. Br J Rheumatol 33:56–59PubMedCrossRef Birrell FN, Adebajo AO, Hazleman BL, Silman AJ (1994) High prevalence of joint laxity in West Africans. Br J Rheumatol 33:56–59PubMedCrossRef
26.
go back to reference Aglietti P, Insall JN, Cerulli G (1983) Patellar pain and incongruence: I. Measurements of incongruence. Clin Orthop 176:217–224PubMed Aglietti P, Insall JN, Cerulli G (1983) Patellar pain and incongruence: I. Measurements of incongruence. Clin Orthop 176:217–224PubMed
27.
go back to reference Boucher JP, King MA, Lefebvre R, Pepin A (1992) Quadriceps femoris muscle activity in patellofemoral pain syndrome. Am J Sports Med 20:527–532PubMedCrossRef Boucher JP, King MA, Lefebvre R, Pepin A (1992) Quadriceps femoris muscle activity in patellofemoral pain syndrome. Am J Sports Med 20:527–532PubMedCrossRef
28.
go back to reference Caylor D, Fites R, Worrell TW (1993) The relationship between quadriceps angle and anterior knee pain syndrome. J Orthop Sports Phys Ther 17:11–16PubMed Caylor D, Fites R, Worrell TW (1993) The relationship between quadriceps angle and anterior knee pain syndrome. J Orthop Sports Phys Ther 17:11–16PubMed
29.
go back to reference Chen S (1997) The experimental study of Q angle variety during knee flexion. Chin J Sports Med 16:91–94 Chen S (1997) The experimental study of Q angle variety during knee flexion. Chin J Sports Med 16:91–94
30.
go back to reference Hvid I, Andersen LI (1982) The quadriceps angle and its relation to femoral torsion. Acta Orthop Scand 53:577–579PubMed Hvid I, Andersen LI (1982) The quadriceps angle and its relation to femoral torsion. Acta Orthop Scand 53:577–579PubMed
31.
go back to reference Hvid I, Andersen LI, Schmidt H (1981) Chondromalacia patellae: the relation to abnormal patellofemoral joint mechanics. Acta Orthop Scand 52:661–666PubMedCrossRef Hvid I, Andersen LI, Schmidt H (1981) Chondromalacia patellae: the relation to abnormal patellofemoral joint mechanics. Acta Orthop Scand 52:661–666PubMedCrossRef
32.
go back to reference Decoster LC, Vailas JC, Lindsay RH, Williams GR (1997) Prevalence and features of joint hypermobility among adolescent athletes. Arch Pediatr Adolesc Med 151:989–992PubMed Decoster LC, Vailas JC, Lindsay RH, Williams GR (1997) Prevalence and features of joint hypermobility among adolescent athletes. Arch Pediatr Adolesc Med 151:989–992PubMed
33.
go back to reference Mikkelsson M, Salminen JJ, Kautiainen H (1996) Joint hypermobility is not a contributing factor to musculoskeletal pain in pre-adolescents. J Rheumatol 23:1963–1967PubMed Mikkelsson M, Salminen JJ, Kautiainen H (1996) Joint hypermobility is not a contributing factor to musculoskeletal pain in pre-adolescents. J Rheumatol 23:1963–1967PubMed
34.
go back to reference Gedalia A, Brewer EJ Jr (1993) Hypermobility in pediatric practice—a review. J Rheumatol 20:371–374PubMed Gedalia A, Brewer EJ Jr (1993) Hypermobility in pediatric practice—a review. J Rheumatol 20:371–374PubMed
35.
go back to reference Arroyo IL, Brewer EJ, Giannini EH (1988) Arthritis/arthralgia and hypermobility of the joints in schoolchildren. J Rheumatol 15:978–980PubMed Arroyo IL, Brewer EJ, Giannini EH (1988) Arthritis/arthralgia and hypermobility of the joints in schoolchildren. J Rheumatol 15:978–980PubMed
36.
go back to reference Gedalia A, Person DA, Brewer EJ Jr, Giannini EH (1985) Hypermobility of the joints in juvenile episodic arthritis/arthralgia. J Pediatr 107:873–876CrossRefPubMed Gedalia A, Person DA, Brewer EJ Jr, Giannini EH (1985) Hypermobility of the joints in juvenile episodic arthritis/arthralgia. J Pediatr 107:873–876CrossRefPubMed
37.
go back to reference Lewkonia RM, Ansell BM (1983) Articular hypermobility simulating chronic rheumatic disease. Arch Dis Child 58:988–992PubMed Lewkonia RM, Ansell BM (1983) Articular hypermobility simulating chronic rheumatic disease. Arch Dis Child 58:988–992PubMed
38.
go back to reference Mikkelsson M (1999) One year outcome of preadolescents with fibromyalgia. J Rheumatol 26:674–682PubMed Mikkelsson M (1999) One year outcome of preadolescents with fibromyalgia. J Rheumatol 26:674–682PubMed
39.
go back to reference Horton MG, Hall TL (1989) Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Phys Ther 69:897–901PubMed Horton MG, Hall TL (1989) Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Phys Ther 69:897–901PubMed
40.
go back to reference Livingston LA (1998) The quadriceps angle: a review of the literature. J Orthop Sports Phys Ther 28:105–109PubMed Livingston LA (1998) The quadriceps angle: a review of the literature. J Orthop Sports Phys Ther 28:105–109PubMed
41.
go back to reference Woodland LH, Francis RS (1992) Parameters and comparisons of the quadriceps angle of college-aged men and women in the supine and standing positions. Am J Sports Med 20:208–211PubMedCrossRef Woodland LH, Francis RS (1992) Parameters and comparisons of the quadriceps angle of college-aged men and women in the supine and standing positions. Am J Sports Med 20:208–211PubMedCrossRef
42.
go back to reference Insall JN, Aglietti P, Tria AJ (1983) Patellar pain and incongruence: II. Clinical application. Clin Orthop 176:225–232PubMed Insall JN, Aglietti P, Tria AJ (1983) Patellar pain and incongruence: II. Clinical application. Clin Orthop 176:225–232PubMed
43.
go back to reference Noll BJ, Ben-Itzhak I, Rossouw P (1988) Modified technique for tibial tubercle elevation with realignment for patellofemoral pain: a preliminary report. Clin Orthop 234:178–182PubMed Noll BJ, Ben-Itzhak I, Rossouw P (1988) Modified technique for tibial tubercle elevation with realignment for patellofemoral pain: a preliminary report. Clin Orthop 234:178–182PubMed
44.
go back to reference Zimbler S, Smith J, Scheller A, Banks HH (1980) Recurrent subluxation and dislocation of the patella in association with athletic injuries. Orthop Clin North Am 11:755–770PubMed Zimbler S, Smith J, Scheller A, Banks HH (1980) Recurrent subluxation and dislocation of the patella in association with athletic injuries. Orthop Clin North Am 11:755–770PubMed
45.
go back to reference Nagamine R, Whiteside LA, White SE, McCarthy DS (1994) Patellar tracking after total knee arthroplasty: the effect of tibial tray malrotation and articular surface configuration. Clin Orthop 304:263–271 Nagamine R, Whiteside LA, White SE, McCarthy DS (1994) Patellar tracking after total knee arthroplasty: the effect of tibial tray malrotation and articular surface configuration. Clin Orthop 304:263–271
46.
go back to reference Paulos L, Rusche K, Johnson C, Noyes FR (1980) Patellar malalignment: a treatment rationale. Phys Ther 60:1624–1632PubMed Paulos L, Rusche K, Johnson C, Noyes FR (1980) Patellar malalignment: a treatment rationale. Phys Ther 60:1624–1632PubMed
47.
go back to reference Guerra JP, Arnold MJ, Gajdosik RL (1994) Q angle: effects of isometric quadriceps contraction and body position. J Orthop Sports Phys Ther 19:200–204PubMed Guerra JP, Arnold MJ, Gajdosik RL (1994) Q angle: effects of isometric quadriceps contraction and body position. J Orthop Sports Phys Ther 19:200–204PubMed
48.
go back to reference Doucette SA, Goble EM (1992) The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Sports Med 20:434–440PubMedCrossRef Doucette SA, Goble EM (1992) The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Sports Med 20:434–440PubMedCrossRef
Metadata
Title
Relationship of Q angle and joint hypermobility and Q angle values in different positions
Authors
Omer Faruk Sendur
Gulcan Gurer
Tuncay Yildirim
Emine Ozturk
Ali Aydeniz
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 3/2006
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-005-0003-6

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