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Blog posts tagged in Awards

8th Biennial ISAKOS Congress • Rio De Janeiro, Brazil • May 15-19, 2011

Patellofemoral Research Excellence Award
The Geometry and Function of the Patellofemoral Joint
Farhad Iranpour, United Kingdom

The purpose of this study was to explore the patellofemoral joint in 3 dimensions, looking at its geometry, motion and stability.

Abstract:

Purpose:
The purpose of this study was to explore the patellofemoral joint in 3 dimensions, looking at its geometry, motion and stability. This work aimed to establish a relationship between this joint and the tibio-femoral joint.
 
Method:
CT scans of 40 normal knees were analysed using custom designed 3D imaging software. A frame of reference was defined, the flexion and extension facets were described in terms of spheres, and the offset of the extension facet sphere centres was measured relative to predefined landmarks. The locations and orientations of the groove and the trochlear axis were examined in relation to the conventional axes of the femur. As for the patella the relationships of various patellar dimensions were studied. In the next part of this study, the kinematics and stability of the patellofemoral joint were measured in 14 fresh frozen cadaveric knees using a Polaris tracking system and an Instron material testing machine after physiologically loading the quadriceps muscles. Then the relationship between these measurements and the femoral trochlear geometry was examined.
 
Results:
It was found that the flexion facets of the femoral condyles were spherical. The medial extension facet could be reproducibly described as part of a larger sphere. However, this was not found to be the case laterally. The trochlear groove was circular and positioned laterally in relation to the mechanical, anatomical, and trans-condylar axes of the femur. It was not co- planar with any of the three axes. The trochlear axis was defined as a line joining the centres of two spheres fitted to the trochlear surfaces, lateral and medial to the trochlear groove. When viewed after aligning the femur to this new axis, the trochlear groove appeared more linear than when other axes were used. The thickness of a patella was on average half of its measured width (correlation coefficient 0.89, p<0.001). The path of the centre of the patella was circular and uniplanar from full flexion to approximately 16° flexion, after which it deviated laterally towards full knee extension. This path was perpendicular to a newly-defined trochlear axis. There were significant correlations between the sulcus angle and the medial facet angle with medial stability(r=0.78, p<0.0001).
 
Conclusion:
The knowledge of the shapes of the surfaces and motion of different compartments of the knee joint and their relationships may help to identify and explain the aetiology of knee joint pathologies. It may also be of use in planning and performing joint reconstruction. These relationships also have implications for the design of unicompartmental and total knee replacements and the rules governing their position. 

 

Once again the Patellofemoral Foundation has generously supported the efforts of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) to encourage research and expertise in the field of patellofemoral disorders. The Patellofemoral Research Excellence Award for 2009 has been won by C. Benjamin Ma and his colleagues Choongsoo Shin, Dana Carpenter and Sharmila Majumdar from the USA for their investigation of patellofemoral joint kinematics in anterior cruciate ligament deficient and reconstructed knees. The award consists of an honorarium whereby the research was presented at the Biennial ISAKOS meeting in Osaka, Japan and may be published in the Arthroscopy journal. For both this award and the Travelling Fellowship Awards, the number and quality of applications has increased substantially compared to two years ago, reflecting the success of the Patellofemoral Foundation in encouraging research and interest in disorders of the patellofemoral joint. ISAKOS is very grateful for the ongoing support of the Foundation. — Julian Feller FRACS Chair, ISAKOS Knee Committee 

The aim of the Patellofemoral Travelling Fellowship is to promote better understanding and communication regarding patellofemoral pain. A stipend is provided by the Foundation to permit visits to several centres worldwide that offer opportunities to learn about the complexities of patellofemoral pain. This year four surgeons will be given the opportunity to benefit from this fellowship. Philip Schoettle from Germany, Petri Sillanpaa from Finland and Christian Lattermann from the USA will travel with Nicola Maffulli from England acting as their “godfather.”

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