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Background <p>Patellar tracking in isolated patellofemoral pain needs further confirmation under dynamic conditions. The present study aimed to analyze the characteristics of patellar tracking and tibial tubercle-trochlear groove (TT-TG<sub>dynamic</sub>) distance during active knee motion in patients with isolated patellofemoral pain (PFP) via dynamic kinematic computed tomography (DKCT), and clarify whether the abnormal patellar tracking and TT-TG<sub>dynamic</sub> distance are associated with isolated PFP.</p> Methods <p>A total of 47 knees with isolated PFP and 47 control knees were scanned with DKCT. The TT-TG<sub>dynamic</sub> distance, bisect offset (BO) index, lateral patellar tilt (LPT), and patellotrochlear index (PTI) were evaluated. All parameters were analyzed by two-factor repeated measures ANOVA.</p> Results <p>In the two groups, the TT-TG<sub>dynamic</sub> distance, BO index, LPT, and PTI varied with the knee flexion angle (all <i>p</i>&lt;0.001). Between the two groups, the variation trends of TT-TG<sub>dynamic</sub> distance and BO index were consistent (<i>p</i> = 0.131, 0.284, respectively), while those of LPT and PTI were significantly different (<i>p</i> = 0.001, &lt;0.001, respectively). The BO index and LPT were significantly higher in the PFP group than those in the control group (<i>p</i> = 0.002, &lt;0.001, respectively), and the PTI was significantly lower in the PFP group than that in the control group (<i>p</i>&lt;0.001), whereas the TT-TG<sub>dynamic</sub> distance showed no significant difference between the two groups (<i>p</i> = 0.631).</p> Conclusions <p>Abnormal lateral patellar displacement, tilt and patellar alta occurred in the absence of increased TT-TG<sub>dynamic</sub> distance in isolated PFP without trochlear dysplasia. Etiologic analysis of isolated PFP should emphasize lateral patellar tracking and patellar height.</p>

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Lateral patellar maltracking and patellar alta in the absence of increased TT-TGdynamic distance in isolated patellofemoral pain: a dynamic kinematic CT study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月5日

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  • Jia Li,
  • Yurou Chen,
  • Mao Yuan,
  • Haitao Yang,
  • Furong Lv,
  • Bo Sheng,
  • Wei Huang

摘要

Background

Patellar tracking in isolated patellofemoral pain needs further confirmation under dynamic conditions. The present study aimed to analyze the characteristics of patellar tracking and tibial tubercle-trochlear groove (TT-TGdynamic) distance during active knee motion in patients with isolated patellofemoral pain (PFP) via dynamic kinematic computed tomography (DKCT), and clarify whether the abnormal patellar tracking and TT-TGdynamic distance are associated with isolated PFP.

Methods

A total of 47 knees with isolated PFP and 47 control knees were scanned with DKCT. The TT-TGdynamic distance, bisect offset (BO) index, lateral patellar tilt (LPT), and patellotrochlear index (PTI) were evaluated. All parameters were analyzed by two-factor repeated measures ANOVA.

Results

In the two groups, the TT-TGdynamic distance, BO index, LPT, and PTI varied with the knee flexion angle (all p<0.001). Between the two groups, the variation trends of TT-TGdynamic distance and BO index were consistent (p = 0.131, 0.284, respectively), while those of LPT and PTI were significantly different (p = 0.001, <0.001, respectively). The BO index and LPT were significantly higher in the PFP group than those in the control group (p = 0.002, <0.001, respectively), and the PTI was significantly lower in the PFP group than that in the control group (p<0.001), whereas the TT-TGdynamic distance showed no significant difference between the two groups (p = 0.631).

Conclusions

Abnormal lateral patellar displacement, tilt and patellar alta occurred in the absence of increased TT-TGdynamic distance in isolated PFP without trochlear dysplasia. Etiologic analysis of isolated PFP should emphasize lateral patellar tracking and patellar height.