Thursday, March 5, 2009

Will a screening Help to detect PFJ disorders:

Say for example as a physical therapist you are assigned to do a screening of 10-12th standard students of a school for anterior knee pain. As a physiotherapist you will definite look for patellar position assessment. Many of us believe that patellar position assessment can detect a faulty patellar position, yes that’s true but does that mean a faulty patellar mechanics associated with faulty patellar position found on assessment will be clinically relevant. Then look at the following literature………

MacIntyre NJ et al did a cross-sectional study:
Purpose of this cross-sectional case-control study was to test the hypothesis that patterns of patellar spin, tilt, and lateral translation make it possible to distinguish individuals with patellofemoral pain syndrome and clinical evidence of patellar malalignment from those with patellofemoral pain syndrome and no clinical evidence of malalignment and from individuals with no knee problems.
60 subjects ware studid by a valid MRI method for patellar position.

According to MacIntyre NJ et al; it cannot be determined from their cross-sectional study whether the more lateral position of the patella in the group with clinical evidence of malalignment preceded or followed the onset of symptoms. It is clear from the data that an individual with patellofemoral pain syndrome cannot be distinguished from a control subject by examining patterns of spin, tilt, or lateral translation of the patella, even when clinical evidence of mechanical abnormality was observed.

MacIntyre NJ et al J Bone Joint Surg Am. 2006 Dec;88(12):2596-605. Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome.

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