| Background. Patellofemoral pain syndrome (PFPS) is a common condition characterized by retropatellar pain which is aggravated by repetitive activities. Proposed etiological factors include variations in patellofemoral structure and alignment as well as altered lower extremity alignment. Purpose. To determine if measures of patellofemoral structure, patellar alignment, quadriceps angle (Q angle) and rearfoot pronation differed in matched samples with and without PEPS and furthermore, to determine whether these measures were related. To investigate the effect of McConnell corrective taping in altering patellar alignment. Hypotheses. (1) Significant differences between PEPS and controls subjects would be found with respect to patellofemoral shape, lateral tilt and displacement of the patella, and clinical measures of Q angle and rearfoot pronation. (2) The radiographic measures (tilt and displacement) would be significantly related to clinical measures (Q angle and pronation) in PEPS subjects. (3) McConnell taping would significantly alter the patellar alignment in the PFPS group. Subjects. Thirty-three volunteers with PEPS (mean age 30.8 years +/- 8.5) and 33 control subjects (31 years +/- 8.4), matched for age, gender and years of military service. Methods. Measures of sulcus and patellar angle, patellar height, patellar tilt (lateral patellar angle) and displacement (congruence angle) were obtained from radiographs in unloaded (knee relaxed), and loaded (isometric quadriceps contraction) conditions with and without corrective taping. Clinical measures included Q angle in standing, and rearfoot pronation (navicular drop and calcaneal valgus). Results. Q angle and rearfoot pronation measures did not differ between groups (paired t-test, p > 0.05) and neither measure was related to patellar tilt or displacement. There was no difference between groups in patellar height, lateral patellar angle or congruence angle in loaded or unloaded conditions (p > 0.05). McConnell taping had no effect on displacement or patellar tilt in either condition (p > 0.05). Conclusions. The study does not support the clinical belief that rearfoot pronation and large Q angle are risk factors for PEPS. Similarly, study results do not support previous research suggesting that lateral patellar tilt and displacement are common features in PFPS. Finally, McConnell taping was not effective in altering patellar tilt or displacement. |
