title: Comparison of patella bone strain between females with and without patellofemoral pain: a finite element analysis study.
abstract: Elevated bone principal strain (an indicator of potential bone injury) resulting from reduced cartilage thickness has been suggested to contribute to patellofemoral symptoms. However, research linking patella bone strain, articular cartilage thickness, and patellofemoral pain (PFP) remains limited. The primary purpose was to determine whether females with PFP exhibit elevated patella bone strain when compared to pain-free controls. A secondary objective was to determine the influence of patella cartilage thickness on patella bone strain. Ten females with PFP and 10 gender, age, and activity-matched pain-free controls participated. Patella bone strain fields were quantified utilizing subject-specific finite element (FE) models of the patellofemoral joint (PFJ). Input parameters for the FE model included (1) PFJ geometry, (2) elastic moduli of the patella bone, (3) weight-bearing PFJ kinematics, and (4) quadriceps muscle forces. Using quasi-static simulations, peak and average minimum principal strains as well as peak and average maximum principal strains were quantified. Cartilage thickness was quantified by computing the perpendicular distance between opposing voxels defining the cartilage edges on axial plane magnetic resonance images. Compared to the pain-free controls, individuals with PFP exhibited increased peak and average minimum and maximum principal strain magnitudes in the patella. Additionally, patella cartilage thickness was negatively associated with peak minimum principal patella strain and peak maximum principal patella strain. The elevated bone strain magnitudes resulting from reduced cartilage thickness may contribute to patellofemoral symptoms and bone injury in persons with PFP.
authors.affiliation: Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA.
authors.forename: Kai-Yu
authors.initials: KY
authors.lastname: Ho
authors.affiliation: Department of Radiological Sciences, University of California, Irvine, CA, USA; Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA.
authors.forename: Joyce H
authors.initials: JH
authors.lastname: Keyak
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA. Electronic address: powers@usc.edu.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Powers
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D002356:Cartilage / Q000503:physiopathology; D002358:Cartilage, Articular / Q000473:pathology; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D008279:Magnetic Resonance Imaging; D010146:Pain; D059408:Pain Management; D010329:Patella / Q000502:physiology*; D057071:Patellofemoral Joint / Q000503:physiopathology*; D052097:Quadriceps Muscle / Q000503:physiopathology; D016474:Weight-Bearing / Q000502:physiology; D055815:Young Adult
keywords: Bone strain; Cartilage thickness; Patella