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Patellofemoral ArthralgiaPatellofemoral ArthralgiaOrthopedics and Neurology DX 612Orthopedics and Neurology DX 612
James J. Lehman, DC, MBA, DABCOUniversity of Bridgeport College of Chiropractic
Patellofemoral Arthralgia Patellofemoral Arthralgia
n Patellofemoral pain syndrome is a descriptive term applied to patients with nonspecific anterior knee pain, and is the most common knee problem.
Anterior Knee PainAnterior Knee Pain
n The pain in most patellofemoral disorders is generalized to the anterior part of the knee.
Quadriceps Angle Quadriceps Angle
n One important concept in patellofemoral joint function is the quadriceps angle (Q-angle).
Q AngleQ Angle
n An invaluable parameter for evaluation of anterior knee pain.
Patellar Tracking Patellar Tracking
n Theoretically, a higher Q-angle increases the lateral pull of the quadriceps femoris muscle on the patella and potentiates patellofemoral disorders.
CONCLUSIONCONCLUSION
n These results substantiate the fact that patients with anterior knee pain have larger Q-angles than healthy individuals.
n Arch Iran Med. 2007 Jan;10(1):24-6.
Normal MeasurementNormal Measurement
Men 11 to 17 degrees Women 14 to 20 degrees
(due to gynecoid pelvis)
Causes of Increased Q AngleCauses of Increased Q Angle
n Genu valgumn Excessive femoral
anteversionn Medial tibial torsionn Laterally positioned
tibial tuberosity
Causes of Increased Q AngleCauses of Increased Q Angle
n Tight lateralretinaculum
n Weakness of vastus medialis oblique
n High riding patella (patella alta)
TherapeuticsTherapeutics
n Reduce pain
TherapeuticsTherapeutics
n Reduce edema
TherapeuticsTherapeutics
n Myofascial treatment for trigger points and contractures
TherapeuticsTherapeutics
n Balance pedal foundation
n Improve posture
TherapeuticsTherapeutics
n Chiropractic manipulation to correct joint dysfunction
Risks of Increased Q AngleRisks of Increased Q Angle
n Patellar subluxation or dislocation