title: In vivo patellofemoral contact mechanics during active extension using a novel dynamic MRI-based methodology.
abstract: OBJECTIVE
  To establish an in vivo, normative patellofemoral (PF) cartilage contact mechanics database acquired during voluntary muscle control using a novel, dynamic, magnetic resonance (MR) imaging-based, computational methodology and validate the contact mechanics sensitivity to the known sub-millimeter methodological accuracies.
  
  
  METHODS
  Dynamic cine phase-contrast and multi-plane cine (MPC) images were acquired while female subjects (n = 20, sample of convenience) performed an open kinetic chain (knee flexion-extension) exercise inside a 3-T MR scanner. Static cartilage models were created from high resolution three-dimensional static MR data and accurately placed in their dynamic pose at each time frame based on the cine-PC (CPC) data. Cartilage contact parameters were calculated based on the surface overlap. Statistical analysis was performed using paired t-test and a one-sample repeated measures ANOVA. The sensitivity of the contact parameters to the known errors in the PF kinematics was determined.
  
  
  RESULTS
  Peak mean PF contact area was 228.7 ± 173.6 mm(2) at 40° knee angle. During extension, contact centroid and peak strain locations tracked medially on the femoral and patellar cartilage and were not significantly different from each other. At 25°, 30°, 35°, and 40° of knee extension, contact area was significantly different. Contact area and centroid locations were insensitive to rotational and translational perturbations.
  
  
  CONCLUSIONS
  This study is a first step towards unfolding the biomechanical pathways to anterior PF pain and osteoarthritis (OA) using dynamic, in vivo, and accurate methodologies. The database provides crucial data for future studies and for validation of, or as an input to, computational models.
authors.affiliation: Functional and Applied Biomechanics Section/Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Borotikar
authors.affiliation: Functional and Applied Biomechanics Section/Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA. Electronic address: fsheehan@cc.nih.gov.
authors.forename: F T
authors.initials: FT
authors.lastname: Sheehan
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000502:physiology*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D057071:Patellofemoral Joint / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D016474:Weight-Bearing; D055815:Young Adult
keywords: Accuracy; Cartilage; Femur; Knee; Magnetic resonance imaging; Osteoarthritis; Patella; Patellofemoral pain syndrome; Sensitivity