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Paper 2
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Patello-femoral mal-alignment is a condition in which the patella is not in the correct position in the femoral groove. It leads to non-specific pain around the patella aggravated by prolonged sitting, squatting, going up stairs and running. Treatment includes orthotics to aid pronation, VMO (Vastus medialis obliques) strengthening exercises, physiotherapy and, in severe cases, surgery.
Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Patellar tendonitis is commonly called Jumper’s Knee because it is most common in athletes whose sports involve frequent jumping such as basketball and volleyball players. But anyone can suffer from patellar tendonitis, including people who don’t participate in jumping sports. It is an injury involving overuse and overstress on the patella tendon.
Fundamentals
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
Sesamoid bones are a special category of bones that are embedded within a tendon. They are sometimes considered to be a sub-category of short bones. The best example of a sesamoid bone is the patella (kneecap), which lies within the tendon of the quadriceps muscle at the knee (see knee – bones). The patella keeps the tendon further away from the joint, which changes the angle of the tendon and enables the quadriceps muscle to produce more torque to move the joint. The pisiform in the wrist is also a sesamoid bone. There are also two small sesamoid bones under the first metatarsal head in the foot, which help to protect the tendons from damage when the foot is on the ground. Sesamoid bones vary in size and shape between people and an individual may have other sesamoid bones in addition to those described.
Patellar fracture among elite-level European soccer players: 4-year case-control cohort analysis of return to play, re-injury, and player performance
Published in The Physician and Sportsmedicine, 2023
Sumit Patel, Ophelie Lavoie-Gagne, Nabil Mehta, Ghassan Farah, Avinaash Korrapati, Brian Forsythe
Patellar fractures most commonly occur through excessive tension on the extensor mechanism (via forceful contraction of quadriceps) or through direct trauma [7]. Patellar fractures can cause weakness in leg extension, knee stiffness, and, chronically, patellofemoral arthritis. Among patellofemoral injuries, patellar fractures appear to have the highest incidence of surgical intervention [8]. Non-displaced fractures with an intact extensor mechanism may be treated through conservative management – cast immobilization followed by progressive range of motion and strengthening exercises. Fractures with displacement (>3 mm displacement or >2 mm of articular incongruity), open fractures, or fractures associated with a deficient extensor mechanism are indications for surgical intervention, which include internal fixation using tension bands, lag screw fixation, partial patellectomy, or total patellectomy [9].
Are subject-specific models necessary to predict patellar tendon fatigue life? A finite element modelling study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Colin R. Firminger, Ifaz T. Haider, Olivia L. Bruce, John W. Wannop, Darren J. Stefanyshyn, W. Brent Edwards
Patellar tendinopathy is a common overuse injury in athletes that perform rapid knee extension maneuvers such as cutting and jumping. The prevalence of patellar tendinopathy is greater than 30% in elite basketball and volleyball athletes (Lian et al. 2005), and 13% in elite soccer athletes (Bode et al. 2017). While several evidence-based rehabilitation protocols for patellar tendinopathy exist (Rutland et al. 2010; Malliaras et al. 2015), this injury is associated with significant morbidity; approximately one third of athletes with patellar tendinopathy experience symptoms lasting more than six months (Cook et al. 1997). The exact pathophysiology of patellar tendinopathy is unknown; however, microdamage accumulation and degenerative alterations characterized by reduced stiffness are known to play a decided role (Helland et al. 2013; Wiesinger et al. 2020).
A descriptive report of the variability in 3D hip and knee kinematics during a single limb squat in women who have patellofemoral pain and visually classified dynamic knee valgus
Published in Physiotherapy Theory and Practice, 2021
Anna M. Di Staulo, Sara A. Scholtes, Gretchen B. Salsich
The following inclusion and exclusion criteria were verified by the principal investigator, a physical therapist, during a clinical screening examination of the knee joint. As part of the initial phone screening, an 11-point numeric pain scale was used to ensure participants had an average daily pain of at least 3/10 and pain duration of greater than 2 months. The clinical screening was used to evaluate the location of the source of pain. Participants had to have pain originating from the patellofemoral articulation (behind or around the patella) (Salsich et al., 2018). Palpation was performed by the principal investigator to rule out pain originating from the patellar tendon, quadriceps tendon, tibiofemoral joint, menisci or synovial plicae. Pain also had to be reproduced by at least two of the following tests: resisted quadriceps contraction, single-limb squat, and step down (Salsich et al., 2018). During the in-person screening, pain was documented via a visual analog scale a 100-mm line with a left anchor of “no pain” and a right anchor of “worst imaginable pain” to confirm the presence of pain in response to the three provocation tests.