Affiliation:
1. Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98122 Messina, Italy
2. D.A. Scientific Research and Internationalization, University of Messina, Via Consolato Del Mare 41, 98121 Messina, Italy
Abstract
Background: Patellar instability can cause pain and disability. A finite element model of a healthy human knee was performed to analyze the role of quadriceps and medial retinaculum imbalance in patellar instability. Methods: The model was created by matching magnetic resonance and computed tomography images of a normal adult patient’s knee. Muscle force intensities were calculated by static optimization, considering the lower limb muscles, knee movement and the ground reaction during walking. Patellar instability was experimentally generated by progressively uncoupling muscular forces, (90 N versus 110 N), while at the same time, the load derived from the quadriceps was gradually reduced by 20%. Results: This loss in force symmetry of 10 N on the retinaculum may produce a displacement of approximately 7 mm, with an increase in patellar contact forces of approximately 44%. When the quadriceps force is reduced by 10% and the unbalanced medial retinaculum acts together, the displacements are in the order of 14 mm, and the patellar contact forces increase by 84%. Conclusion: A reduced quadriceps force alone is not able to cause significant patellar instability, while an imbalance of forces at the level of the retinaculum could lead to patellar instability, especially when the two effects are combined. A better understanding of joint relationships and muscle synergies can help to improve clinical approaches to patella instability
Subject
Fluid Flow and Transfer Processes,Computer Science Applications,Process Chemistry and Technology,General Engineering,Instrumentation,General Materials Science
Cited by
1 articles.
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