Patellar tilt correlates with vastus lateralis:vastus medialis activation ratio in maltracking patellofemoral pain patients

Saikat Pal, Thor F. Besier, Christine E. Draper, Michael Fredericson, Garry E. Gold, Gary S. Beaupre, Scott L. Delp

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

Patellofemoral (PF) pain is a common ailment of the lower extremity. A theorized cause for pain is patellar maltracking due to vasti muscle activation imbalance, represented as large vastus lateralis:vastus medialis (VL:VM) activation ratios. However, evidence relating vasti muscle activation imbalance to patellar maltracking is limited. The purpose of this study was to investigate the relationship between VL:VM activation ratio and patellar tracking measures, patellar tilt and bisect offset, in PF pain subjects and pain-free controls. We evaluated VL:VM activation ratio and VM activation delay relative to VL activation in 39 PF pain subjects and 15 pain-free controls during walking. We classified the PF pain subjects into normal tracking and maltracking groups based on patellar tilt and bisect offset measured from weight-bearing magnetic resonance imaging. Patellar tilt correlated with VL:VM activation ratio only in PF pain subjects classified as maltrackers. This suggests that a clinical intervention targeting vasti muscle activation imbalance may be effective only in PF pain subjects classified as maltrackers.

Original languageEnglish (US)
Pages (from-to)927-933
Number of pages7
JournalJournal of Orthopaedic Research
Volume30
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Keywords

  • Patellar maltracking
  • Patellofemoral pain
  • PearlDiver database
  • Vastus lateralis:vastus medialis activation ratio
  • Vastus medialis activation delay

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