Patellofemoral cartilage stresses are most sensitive to variations in vastus medialis muscle forces

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

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The purpose of this study was to evaluate the effects of variations in quadriceps muscle forces on patellofemoral stress. We created subject-specific finite element models for 21 individuals with chronic patellofemoral pain and 16 pain-free control subjects. We extracted three-dimensional geometries from high resolution magnetic resonance images and registered the geometries to magnetic resonance images from an upright weight bearing squat with the knees flexed at 60°. We estimated quadriceps muscle forces corresponding to 60° knee flexion during a stair climb task from motion analysis and electromyography-driven musculoskeletal modelling. We applied the quadriceps muscle forces to our finite element models and evaluated patellofemoral cartilage stress. We quantified cartilage stress using an energy-based effective stress, a scalar quantity representing the local stress intensity in the tissue. We used probabilistic methods to evaluate the effects of variations in quadriceps muscle forces from five trials of the stair climb task for each subject. Patellofemoral effective stress was most sensitive to variations in forces in the two branches of the vastus medialis muscle. Femur cartilage effective stress was most sensitive to variations in vastus medialis forces in 29/37 (78%) subjects, and patella cartilage effective stress was most sensitive to variations in vastus medialis forces in 21/37 (57%) subjects. Femur cartilage effective stress was more sensitive to variations in vastus medialis longus forces in subjects classified as maltrackers compared to normal tracking subjects (p = 0.006). This study provides new evidence of the importance of the vastus medialis muscle in the treatment of patellofemoral pain.

Original languageEnglish (US)
Pages (from-to)206-216
Number of pages11
JournalComputer Methods in Biomechanics and Biomedical Engineering
Volume22
Issue number2
DOIs
StatePublished - Jan 25 2019

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Biomedical Engineering
  • Human-Computer Interaction
  • Computer Science Applications

Keywords

  • Patellofemoral pain
  • finite element modelling
  • patellofemoral stress
  • probabilistic modelling
  • quadriceps force
  • vastus medialis

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