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Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion
Purpose The purpose of the study was to evaluate the frontal gait patterns in patients with chronic patellofemoral instability compared to healthy controls. The hypothesis was that internal-rotation–adduction moment of the knee as altered dynamic Q-angle is evident in patients and correlates positiv...
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| Published in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2021-04, Vol.29 (4), p.1224-1231 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Imhoff, Florian B. Cotic, Matthias Dyrna, Felix G. E. Cote, Mark Diermeier, Theresa Achtnich, Andrea Imhoff, Andreas B. Beitzel, Knut |
| description | Purpose
The purpose of the study was to evaluate the frontal gait patterns in patients with chronic patellofemoral instability compared to healthy controls. The hypothesis was that internal-rotation–adduction moment of the knee as altered dynamic Q-angle is evident in patients and correlates positively with increased femoral torsion.
Methods
Thirty-five patients with symptomatic recurrent patellofemoral instability requiring surgical treatment were matched for average age, sex, and body mass index with 15 healthy controls (30 knees). Several clinical and radiographic measurements were taken from each participant: internal and external rotation (hipIR, hipER), Q-angle, tubercle sulcus angle (TS-angle), femoral antetorsion (femAT), tibial tubercle–trochlear groove (TT-TG) distance, and frontal leg axis. Additionally, three frontal gait patterns were defined and recorded: (1) internal-rotation–adduction moment of the knee during normal walking, (2) dynamic valgus of the knee, and (3) Trendelenburg’s sign in a single-leg squat. Randomized videography was evaluated by three independent blinded observers. Statistical analysis was performed using regression models and comparisons of gait patterns and clinical and radiological measurements. Furthermore, observer reliability was correlated to gradings of radiological parameters.
Results
Patients showed altered dynamic Q-angle gait pattern during normal walking (
p
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| doi_str_mv | 10.1007/s00167-020-06163-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2425590121</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2425590121</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-be30d5c4c679a6b702d6f6c8f15de49c2bb41146c9e64bc5f0179e49f9a86ef43</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS1ERIbAD7BAltiwMZTdfkwvUXhKkVCkZG253dWJo257sD2gWfHreOgEJBasqlR17i1bl5AXHN5wAPO2AHBtGAhgoLnumH5ENlx2HTOdNI_JBnopmAClT8nTUu4AWiv7J-S0E3rbELMhP98foluCp5fMxZsZaSg0RJ_RFRxbR3euBoy10B-h3lJ_m1NsdJviPKcJl5Td3LhS3RDmUA_UxZH6lDPOjSl0l0qo4TvOh9XhQVJTLiHFZ-RkcnPB5_f1jFx__HB1_pldfP305fzdBfOdUZUN2MGovPTa9E4PBsSoJ-23E1cjyt6LYZCcS-171HLwagJu-raYerfVOMnujLxefXc5fdtjqXYJxbc_uIhpX6yQQqkeuOANffUPepf2ObbXWaHgiBmlGyVWyudUSsbJ7nJYXD5YDvYYj13jsS0e-zseexS9vLfeDwuOfyQPeTSgW4HSVvEG89_b_7H9BQ1SnVE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2502559756</pqid></control><display><type>article</type><title>Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion</title><source>Wiley-Blackwell Read & Publish Collection</source><source>Springer Link</source><source>SPORTDiscus with Full Text</source><creator>Imhoff, Florian B. ; Cotic, Matthias ; Dyrna, Felix G. E. ; Cote, Mark ; Diermeier, Theresa ; Achtnich, Andrea ; Imhoff, Andreas B. ; Beitzel, Knut</creator><creatorcontrib>Imhoff, Florian B. ; Cotic, Matthias ; Dyrna, Felix G. E. ; Cote, Mark ; Diermeier, Theresa ; Achtnich, Andrea ; Imhoff, Andreas B. ; Beitzel, Knut</creatorcontrib><description>Purpose
The purpose of the study was to evaluate the frontal gait patterns in patients with chronic patellofemoral instability compared to healthy controls. The hypothesis was that internal-rotation–adduction moment of the knee as altered dynamic Q-angle is evident in patients and correlates positively with increased femoral torsion.
Methods
Thirty-five patients with symptomatic recurrent patellofemoral instability requiring surgical treatment were matched for average age, sex, and body mass index with 15 healthy controls (30 knees). Several clinical and radiographic measurements were taken from each participant: internal and external rotation (hipIR, hipER), Q-angle, tubercle sulcus angle (TS-angle), femoral antetorsion (femAT), tibial tubercle–trochlear groove (TT-TG) distance, and frontal leg axis. Additionally, three frontal gait patterns were defined and recorded: (1) internal-rotation–adduction moment of the knee during normal walking, (2) dynamic valgus of the knee, and (3) Trendelenburg’s sign in a single-leg squat. Randomized videography was evaluated by three independent blinded observers. Statistical analysis was performed using regression models and comparisons of gait patterns and clinical and radiological measurements. Furthermore, observer reliability was correlated to gradings of radiological parameters.
Results
Patients showed altered dynamic Q-angle gait pattern during normal walking (
p
< 0.001) compared to healthy controls (interrater kappa = 0.61), whereas highest observer agreement was reported if femAT was greater than 20° (kappa = 0.85). Logistic regression model revealed higher femAT (18.2° ± 12.5 versus 11.9° ± 7.0 (
p
= 0.004) as a significant variable, as well as lower TT–TG distance (23.6 mm ± 2.8 vs. 16.6 mm ± 4.9,
p
= 0.004) on evident dynamic Q-angle gait pattern. Dynamic valgus in a single-leg squat was observed significantly more often in patients (
p
< 0.001) compared to controls (interrater kappa = 0.7). However, besides the static measured Q-angle as the only significant variable on evident dynamic valgus pattern (13.6° ± 4.6 vs. 10.3° ± 5.2,
p
= 0.003), no radiological parameter was detected to correlate significantly with dynamic valgus and Trendelenburg's sign (n.s.).
Conclusions
Clinical detection of pathologic torsion and bony alignment may be difficult in patients with patellofemoral instability. The present study demonstrated that dynamic Q-angle gait pattern is significantly altered in patients with chronic patellofemoral instability compared to healthy controls. Moreover, dynamic Q-angle correlates positively with higher femoral torsion and negatively with higher TT–TG distance. Therefore, clinical and radiological assessment of maltorsion should be added to the standard diagnostic workup in cases of patellofemoral instability.
Level of evidence
Level II.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-020-06163-6</identifier><identifier>PMID: 32683477</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Biomedical materials ; Body mass ; Body mass index ; Body size ; Control stability ; Correlation analysis ; Dynamic stability ; Evaluation ; Female ; Femur ; Femur - diagnostic imaging ; Femur - physiopathology ; Gait ; Gait Analysis ; Grooves ; Humans ; Instability ; Joint Instability - diagnostic imaging ; Joint Instability - physiopathology ; Knee ; Leg ; Male ; Medicine ; Medicine & Public Health ; Orthopedics ; Parameters ; Patellofemoral Joint - diagnostic imaging ; Patellofemoral Joint - physiopathology ; Patients ; Prospective Studies ; Radiography ; Recurrence ; Regression analysis ; Regression models ; Reproducibility of Results ; Rotation ; Stability analysis ; Statistical analysis ; Tibia - diagnostic imaging ; Tibia - physiopathology ; Videography ; Walking ; Young Adult</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-04, Vol.29 (4), p.1224-1231</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-be30d5c4c679a6b702d6f6c8f15de49c2bb41146c9e64bc5f0179e49f9a86ef43</citedby><cites>FETCH-LOGICAL-c375t-be30d5c4c679a6b702d6f6c8f15de49c2bb41146c9e64bc5f0179e49f9a86ef43</cites><orcidid>0000-0002-2159-2071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32683477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Imhoff, Florian B.</creatorcontrib><creatorcontrib>Cotic, Matthias</creatorcontrib><creatorcontrib>Dyrna, Felix G. E.</creatorcontrib><creatorcontrib>Cote, Mark</creatorcontrib><creatorcontrib>Diermeier, Theresa</creatorcontrib><creatorcontrib>Achtnich, Andrea</creatorcontrib><creatorcontrib>Imhoff, Andreas B.</creatorcontrib><creatorcontrib>Beitzel, Knut</creatorcontrib><title>Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
The purpose of the study was to evaluate the frontal gait patterns in patients with chronic patellofemoral instability compared to healthy controls. The hypothesis was that internal-rotation–adduction moment of the knee as altered dynamic Q-angle is evident in patients and correlates positively with increased femoral torsion.
Methods
Thirty-five patients with symptomatic recurrent patellofemoral instability requiring surgical treatment were matched for average age, sex, and body mass index with 15 healthy controls (30 knees). Several clinical and radiographic measurements were taken from each participant: internal and external rotation (hipIR, hipER), Q-angle, tubercle sulcus angle (TS-angle), femoral antetorsion (femAT), tibial tubercle–trochlear groove (TT-TG) distance, and frontal leg axis. Additionally, three frontal gait patterns were defined and recorded: (1) internal-rotation–adduction moment of the knee during normal walking, (2) dynamic valgus of the knee, and (3) Trendelenburg’s sign in a single-leg squat. Randomized videography was evaluated by three independent blinded observers. Statistical analysis was performed using regression models and comparisons of gait patterns and clinical and radiological measurements. Furthermore, observer reliability was correlated to gradings of radiological parameters.
Results
Patients showed altered dynamic Q-angle gait pattern during normal walking (
p
< 0.001) compared to healthy controls (interrater kappa = 0.61), whereas highest observer agreement was reported if femAT was greater than 20° (kappa = 0.85). Logistic regression model revealed higher femAT (18.2° ± 12.5 versus 11.9° ± 7.0 (
p
= 0.004) as a significant variable, as well as lower TT–TG distance (23.6 mm ± 2.8 vs. 16.6 mm ± 4.9,
p
= 0.004) on evident dynamic Q-angle gait pattern. Dynamic valgus in a single-leg squat was observed significantly more often in patients (
p
< 0.001) compared to controls (interrater kappa = 0.7). However, besides the static measured Q-angle as the only significant variable on evident dynamic valgus pattern (13.6° ± 4.6 vs. 10.3° ± 5.2,
p
= 0.003), no radiological parameter was detected to correlate significantly with dynamic valgus and Trendelenburg's sign (n.s.).
Conclusions
Clinical detection of pathologic torsion and bony alignment may be difficult in patients with patellofemoral instability. The present study demonstrated that dynamic Q-angle gait pattern is significantly altered in patients with chronic patellofemoral instability compared to healthy controls. Moreover, dynamic Q-angle correlates positively with higher femoral torsion and negatively with higher TT–TG distance. Therefore, clinical and radiological assessment of maltorsion should be added to the standard diagnostic workup in cases of patellofemoral instability.
Level of evidence
Level II.</description><subject>Adult</subject><subject>Biomedical materials</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Control stability</subject><subject>Correlation analysis</subject><subject>Dynamic stability</subject><subject>Evaluation</subject><subject>Female</subject><subject>Femur</subject><subject>Femur - diagnostic imaging</subject><subject>Femur - physiopathology</subject><subject>Gait</subject><subject>Gait Analysis</subject><subject>Grooves</subject><subject>Humans</subject><subject>Instability</subject><subject>Joint Instability - diagnostic imaging</subject><subject>Joint Instability - physiopathology</subject><subject>Knee</subject><subject>Leg</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Parameters</subject><subject>Patellofemoral Joint - diagnostic imaging</subject><subject>Patellofemoral Joint - physiopathology</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Recurrence</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Reproducibility of Results</subject><subject>Rotation</subject><subject>Stability analysis</subject><subject>Statistical analysis</subject><subject>Tibia - diagnostic imaging</subject><subject>Tibia - physiopathology</subject><subject>Videography</subject><subject>Walking</subject><subject>Young Adult</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kctuFDEQRS1ERIbAD7BAltiwMZTdfkwvUXhKkVCkZG253dWJo257sD2gWfHreOgEJBasqlR17i1bl5AXHN5wAPO2AHBtGAhgoLnumH5ENlx2HTOdNI_JBnopmAClT8nTUu4AWiv7J-S0E3rbELMhP98foluCp5fMxZsZaSg0RJ_RFRxbR3euBoy10B-h3lJ_m1NsdJviPKcJl5Td3LhS3RDmUA_UxZH6lDPOjSl0l0qo4TvOh9XhQVJTLiHFZ-RkcnPB5_f1jFx__HB1_pldfP305fzdBfOdUZUN2MGovPTa9E4PBsSoJ-23E1cjyt6LYZCcS-171HLwagJu-raYerfVOMnujLxefXc5fdtjqXYJxbc_uIhpX6yQQqkeuOANffUPepf2ObbXWaHgiBmlGyVWyudUSsbJ7nJYXD5YDvYYj13jsS0e-zseexS9vLfeDwuOfyQPeTSgW4HSVvEG89_b_7H9BQ1SnVE</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Imhoff, Florian B.</creator><creator>Cotic, Matthias</creator><creator>Dyrna, Felix G. E.</creator><creator>Cote, Mark</creator><creator>Diermeier, Theresa</creator><creator>Achtnich, Andrea</creator><creator>Imhoff, Andreas B.</creator><creator>Beitzel, Knut</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2159-2071</orcidid></search><sort><creationdate>20210401</creationdate><title>Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion</title><author>Imhoff, Florian B. ; Cotic, Matthias ; Dyrna, Felix G. E. ; Cote, Mark ; Diermeier, Theresa ; Achtnich, Andrea ; Imhoff, Andreas B. ; Beitzel, Knut</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-be30d5c4c679a6b702d6f6c8f15de49c2bb41146c9e64bc5f0179e49f9a86ef43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Biomedical materials</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Control stability</topic><topic>Correlation analysis</topic><topic>Dynamic stability</topic><topic>Evaluation</topic><topic>Female</topic><topic>Femur</topic><topic>Femur - diagnostic imaging</topic><topic>Femur - physiopathology</topic><topic>Gait</topic><topic>Gait Analysis</topic><topic>Grooves</topic><topic>Humans</topic><topic>Instability</topic><topic>Joint Instability - diagnostic imaging</topic><topic>Joint Instability - physiopathology</topic><topic>Knee</topic><topic>Leg</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Parameters</topic><topic>Patellofemoral Joint - diagnostic imaging</topic><topic>Patellofemoral Joint - physiopathology</topic><topic>Patients</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Recurrence</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Reproducibility of Results</topic><topic>Rotation</topic><topic>Stability analysis</topic><topic>Statistical analysis</topic><topic>Tibia - diagnostic imaging</topic><topic>Tibia - physiopathology</topic><topic>Videography</topic><topic>Walking</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Imhoff, Florian B.</creatorcontrib><creatorcontrib>Cotic, Matthias</creatorcontrib><creatorcontrib>Dyrna, Felix G. E.</creatorcontrib><creatorcontrib>Cote, Mark</creatorcontrib><creatorcontrib>Diermeier, Theresa</creatorcontrib><creatorcontrib>Achtnich, Andrea</creatorcontrib><creatorcontrib>Imhoff, Andreas B.</creatorcontrib><creatorcontrib>Beitzel, Knut</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Imhoff, Florian B.</au><au>Cotic, Matthias</au><au>Dyrna, Felix G. E.</au><au>Cote, Mark</au><au>Diermeier, Theresa</au><au>Achtnich, Andrea</au><au>Imhoff, Andreas B.</au><au>Beitzel, Knut</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>29</volume><issue>4</issue><spage>1224</spage><epage>1231</epage><pages>1224-1231</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
The purpose of the study was to evaluate the frontal gait patterns in patients with chronic patellofemoral instability compared to healthy controls. The hypothesis was that internal-rotation–adduction moment of the knee as altered dynamic Q-angle is evident in patients and correlates positively with increased femoral torsion.
Methods
Thirty-five patients with symptomatic recurrent patellofemoral instability requiring surgical treatment were matched for average age, sex, and body mass index with 15 healthy controls (30 knees). Several clinical and radiographic measurements were taken from each participant: internal and external rotation (hipIR, hipER), Q-angle, tubercle sulcus angle (TS-angle), femoral antetorsion (femAT), tibial tubercle–trochlear groove (TT-TG) distance, and frontal leg axis. Additionally, three frontal gait patterns were defined and recorded: (1) internal-rotation–adduction moment of the knee during normal walking, (2) dynamic valgus of the knee, and (3) Trendelenburg’s sign in a single-leg squat. Randomized videography was evaluated by three independent blinded observers. Statistical analysis was performed using regression models and comparisons of gait patterns and clinical and radiological measurements. Furthermore, observer reliability was correlated to gradings of radiological parameters.
Results
Patients showed altered dynamic Q-angle gait pattern during normal walking (
p
< 0.001) compared to healthy controls (interrater kappa = 0.61), whereas highest observer agreement was reported if femAT was greater than 20° (kappa = 0.85). Logistic regression model revealed higher femAT (18.2° ± 12.5 versus 11.9° ± 7.0 (
p
= 0.004) as a significant variable, as well as lower TT–TG distance (23.6 mm ± 2.8 vs. 16.6 mm ± 4.9,
p
= 0.004) on evident dynamic Q-angle gait pattern. Dynamic valgus in a single-leg squat was observed significantly more often in patients (
p
< 0.001) compared to controls (interrater kappa = 0.7). However, besides the static measured Q-angle as the only significant variable on evident dynamic valgus pattern (13.6° ± 4.6 vs. 10.3° ± 5.2,
p
= 0.003), no radiological parameter was detected to correlate significantly with dynamic valgus and Trendelenburg's sign (n.s.).
Conclusions
Clinical detection of pathologic torsion and bony alignment may be difficult in patients with patellofemoral instability. The present study demonstrated that dynamic Q-angle gait pattern is significantly altered in patients with chronic patellofemoral instability compared to healthy controls. Moreover, dynamic Q-angle correlates positively with higher femoral torsion and negatively with higher TT–TG distance. Therefore, clinical and radiological assessment of maltorsion should be added to the standard diagnostic workup in cases of patellofemoral instability.
Level of evidence
Level II.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32683477</pmid><doi>10.1007/s00167-020-06163-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2159-2071</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-04, Vol.29 (4), p.1224-1231 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2425590121 |
| source | Wiley-Blackwell Read & Publish Collection; Springer Link; SPORTDiscus with Full Text |
| subjects | Adult Biomedical materials Body mass Body mass index Body size Control stability Correlation analysis Dynamic stability Evaluation Female Femur Femur - diagnostic imaging Femur - physiopathology Gait Gait Analysis Grooves Humans Instability Joint Instability - diagnostic imaging Joint Instability - physiopathology Knee Leg Male Medicine Medicine & Public Health Orthopedics Parameters Patellofemoral Joint - diagnostic imaging Patellofemoral Joint - physiopathology Patients Prospective Studies Radiography Recurrence Regression analysis Regression models Reproducibility of Results Rotation Stability analysis Statistical analysis Tibia - diagnostic imaging Tibia - physiopathology Videography Walking Young Adult |
| title | Dynamic Q-angle is increased in patients with chronic patellofemoral instability and correlates positively with femoral torsion |
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