Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005 / Patellofemoral Pain Syndrome (PFPS) is a common knee problem that affects 25% of the general population. PFPS generally affects adolescents, especially females, young adults and sports men and women. PFPS is defined as anterior knee pain arising from dysfunction of the patellofemoral articulation including its connective and contractile tissues. Literature suggests an extensor mechanism dysfunction as the most probable etiology. The majority of literature suggests that PFPS is associated with restricted patella motion, especially medial glide, resulting from a tight lateral retinaculum and/or tight iliotibial band. The beneficial effect of patella mobilization in the management of PFPS, suggested by the results of a number of studies, further suggests that restricted patella motion may be an integral feature of PFPS, as a causative and/or perpetuating factor. The purpose of this study was to assess the associations between the severity of PFPS (in terms of the objective and subjective clinical measures) and patella mobility (direction of mobility loss and degree of motion loss). / M

Total knee arthroplasty is a widely used and relatively successful procedure, designed to relieve pain and restore function to patients suffering from osteoarthritis. However, satisfaction following the procedure is low. One of the primary sources of pain and a cause of functional limitations following knee arthroplasty is the patellofemoral joint. Reasons for pain in the patellofemoral joint are not well understood but adverse patellofemoral biomechanics are thought to contribute. Many in vitro methods exist for the investigation of patellofemoral joint biomechanics but there is no consistent standard protocol. It is therefore difficult to draw any general conclusions regarding the effect of specific design or alignment factors on the biomechanics of the patellofemoral joint. The present study aimed to improve current understanding of factors contributing to patellofemoral complications. A knee simulator, which was based on the Oxford Knee Rig and included synthetic models for a number of soft tissue and bony structures, was developed. The simulator was demonstrated to provide a simplified but physiologically relevant model of the human knee, which allowed effective assessment of patellofemoral joint biomechanics under physiological loads. The system eliminated the need for cadaveric tissue and therefore demonstrated reduced variability, enabling the efficient assessment of a number of potentially influencing factors. A number of investigations were carried out using the simulator to assess the effect of patella component design and position, and femoral component alignment on patellofemoral biomechanics using the Scorpio NRG system. The results of these studies indicate the benefit of medialisation of the apex of the patella component and warn against excessive femoral component sagittal plane malalignment. However, in general they indicated the relatively forgiving nature of the Scorpio system to malalignment and highlighted that irrespective of alignment and patella component design, pressures in excess of material limits are frequently achieved in deep flexion.

Thesis (M.S.E.S.)--University of Toledo, 2009. / Typescript. "Submitted as partial fulfillment of the requirements for The Master of Science degree in Exercise Science." "A thesis entitled"--at head of title. Bibliography: leaves 57-61.

Thesis (Ph.D.)--University of Delaware, 2009. / Principal faculty advisor: Irene S. Davis, Dept. of Physical Therapy. Includes bibliographical references.

Thesis (M.S.)--University of British Columbia, 2003. / Includes bibliographical references (leaves 94-97).

The patellofemoral joint (PFJ) is a common source of problems in Orthopaedics and is the source of poorly defined pain and poor function in both normal and replaced knees. Before problems of the PFJ can be fully comprehended a better understanding of the basic form and function of the PFJ is required. The aim of this thesis therefore is to investigate the shape and kinematics of the PFJ and their inter-relations in both normal and replaced knees. The first part of this thesis was concerned with the shape (or form) of the PFJ. Species from the human ancestry over the previous 400 million years were assembled and measurements taken from three dimensional, CT reconstructions, allowing the descriptions of evolutionary changes in the shape, and orientation of the patellofemoral joint in relation to the tibiofemoral compartments. The study chronicled the dramatic changes that occurred in relation to the adoption of the erect bipedal hominin stance which has resulted in varied anatomy at the PFJ, predisposing it to a wide range of pathologies. The articular surface geometry of normal human patellofemoral joints (bone and cartilage) were compared with those of total knee replacements, and patellofemoral joint replacements. Mapping of the trajectory of the apex of the trochlea groove revealed significant differences between native and replaced knees, with the trajectory being orientated laterally in normal knees and either centrally or medially in replaced knees. The second part of this work was concerned with the kinematics (or function) of the PFJ. With current technology it is impossible to measure coronal plane PFJ kinematics with any accuracy in both native and replaced knees. A novel method was developed combining Motion Analysis and UltraSound (MAUS). Validation experiments were undertaken that demonstrated acceptable error (1.8 mm). The MAUS technique was used to show statistically significant differences between the coronal plane kinematics of the patella in normal and replaced knees. In particular in some arthroplasty patients, the patella tracked in the opposite direction to that in normal subjects. The abnormal kinematics were a manifestation of non-anatomical joint replacements. This demonstrates that form and function are closely related. The interaction between form and function in the knee was further investigated using patients with anterior knee pain. Assessment was made of the relationship between patellar subluxation and multiple bony, cartilaginous and soft-tissue factors potentially predisposing to subluxation. The percentage of engagement of the patella in the trochlear groove in knee extension showed the strongest relationship with subluxation, with subjects less than 30% engaged tending to subluxate. This suggests that the most important factor in preventing subluxation is patellar engagement. A clinical study is now required to assess the effect of surgery aimed at improving engagement. The detailed insights into the variability of form and function in the PFJ obtained throughout this thesis will help address pathology in the native knee and guide decisions for new designs of knee replacements. A novel technology has been developed here for measuring patella kinematics which has great potential for future research. The MAUS technique will provide a clinical investigative tool and allow investigation into kinematic abnormalities in other joints.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of the investigation was to evaluate the presence and extent of Quadriceps Femoris weakness in subjects with patellofemoral pain syndrome by the use of an isokinetic dynamometer. / M

Thesis (M.S.)--Boise State University, 2009. / Includes abstract. Includes bibliographical references (leaves 32-36).

Thesis (M.S.)--Boise State University, 2009. / Title from t.p. of PDF file (viewed May 5, 2010). Includes abstract. Includes bibliographical references (leaves 32-36).

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic,Durban Institute of Technology, 2005 xx, 116 leaves ; 30 cm / Patellofemoral Pain Syndrome (PFPS) is a common knee problem that affects 25% of the general population. PFPS generally affects adolescents, especially females, young adults and sports men and women. PFPS is defined as anterior knee pain arising from dysfunction of the patellofemoral articulation including its connective and contractile tissues. Literature suggests an extensor mechanism dysfunction as the most probable etiology. The majority of literature suggests that PFPS is associated with restricted patella motion, especially medial glide, resulting from a tight lateral retinaculum and/or tight iliotibial band. The beneficial effect of patella mobilization in the management of PFPS, suggested by the results of a number of studies, further suggests that restricted patella motion may be an integral feature of PFPS, as a causative and/or perpetuating factor. The purpose of this study was to assess the associations between the severity of PFPS (in terms of the objective and subjective clinical measures) and patella mobility (direction of mobility loss and degree of motion loss).