Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome
Introduction An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis. Materials...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2009-08, Vol.129 (8), p.1025-1030 |
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| creator | Bohnsack, Michael Klages, Phillip Hurschler, Christof Halcour, Andre Wilharm, Arne Ostermeier, Sven Rühmann, Oliver Wirth, Carl-Joachim |
| description | Introduction
An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis.
Materials and methods
Isokinetic knee extension from 120° of flexion to full extension was simulated on 10 human knee cadaver specimens (six males, four females, average age at death 42 years) using a knee kinemator. Joint kinematics was evaluated by ultrasound sensors (CMS 100
TM
, Zebris, Isny, Germany), and retro-patellar contact pressure was measured using a thin-film resistive ink pressure system (K-Scan
TM
4000, Tekscan, Boston). Infrapatellar tissue pressure was analyzed using a closed sensor cell which was implanted inside the fat pad (GISMA, Buggingen, Germany). An inflatable fluid cell was implanted by ultrasound control in the center of the infrapatellar fat pad and filled subsequently with water to simulate a fat pad edema. All parameters were recorded and analyzed from 0 to 5 ml volume of the fluid cell.
Results
Simulating a fat pad edema resulted in a significant (
P
|
| doi_str_mv | 10.1007/s00402-006-0237-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67420675</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2261986816</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-e6324a65e15742f1294f2486878148b9614a5a9fe75a941fdd6171bf9a3654fb3</originalsourceid><addsrcrecordid>eNp1kUFrFjEQhoMo9mv1B3iRgOBtNZNkk403KWoLBS96DtndiU27m6zJ7qH9If5e87EfFAQvCcw87zszvIS8AfYBGNMfC2OS8YYx1TAudPP4jBxACtkIA-o5OTAjVNOxFs7IeSl3jAHvDHtJzkCzVhjZHsif6-inDeOANHnqIg3RZ7e4FafJZerdShc3UhxxdjRFuneSxzllN9E-pBmHWxfDUKp6pPcRkd6HWPG11j5RR5dUSugnpBmnWqwma6LrLVZ-xRxS3kWLC5GWhzjmavmKvPBuKvj69F-Qn1-__Li8am6-f7u-_HzTDEKztUEluHSqRWi15B64kZ7LTnW6A9n1RoF0rTMedX0l-HFUoKH3xgnVSt-LC_J-911y-r1hWe0cynC8PWLailXVlindVvDdP-Bd2nKsu1nOFZg6E1SlYKeGXI_O6O2Sw-zygwVmj5HZPTJbI7PHyOxj1bw9OW_9jOOT4pRRBfgOlNqKvzA_jf6_61-tb6Mv</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2261986816</pqid></control><display><type>article</type><title>Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Bohnsack, Michael ; Klages, Phillip ; Hurschler, Christof ; Halcour, Andre ; Wilharm, Arne ; Ostermeier, Sven ; Rühmann, Oliver ; Wirth, Carl-Joachim</creator><creatorcontrib>Bohnsack, Michael ; Klages, Phillip ; Hurschler, Christof ; Halcour, Andre ; Wilharm, Arne ; Ostermeier, Sven ; Rühmann, Oliver ; Wirth, Carl-Joachim</creatorcontrib><description>Introduction
An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis.
Materials and methods
Isokinetic knee extension from 120° of flexion to full extension was simulated on 10 human knee cadaver specimens (six males, four females, average age at death 42 years) using a knee kinemator. Joint kinematics was evaluated by ultrasound sensors (CMS 100
TM
, Zebris, Isny, Germany), and retro-patellar contact pressure was measured using a thin-film resistive ink pressure system (K-Scan
TM
4000, Tekscan, Boston). Infrapatellar tissue pressure was analyzed using a closed sensor cell which was implanted inside the fat pad (GISMA, Buggingen, Germany). An inflatable fluid cell was implanted by ultrasound control in the center of the infrapatellar fat pad and filled subsequently with water to simulate a fat pad edema. All parameters were recorded and analyzed from 0 to 5 ml volume of the fluid cell.
Results
Simulating a fat pad edema resulted in a significant (
P
< 0.01) increase of the infrapatellar fat pad pressure (247 mbar at 0 ml to 615 mbar at 5 ml volume). In knee extension and flexion the patella flexion (sagittal plane) was decreased while we did not find any other significant influence of the edema on knee kinematics. During the analysis of the patellofemoral biomechanics, a simulated fat pad edema resulted in a significant (
P
< 0.05) decrease of the patellofemoral force between 120° of knee flexion and full extension. The contact area was reduced significantly near extension (0°–30°) by an average of 10% while the contact pressure was reduced at the entire range of motion up to 20%.
Conclusion
An edema of the infrapatellar fat pad does not cause an increase of the patellofemoral pressure or a significant alteration of the patellofemoral glide mechanism. Anterior knee pain in case of a fat pad edema may be related to a significant increase of the tissue pressure and possible histochemical reactions.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-006-0237-z</identifier><identifier>PMID: 17053945</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adipose Tissue ; Adult ; Arthroplasty - adverse effects ; Arthroscopy and Sports Medicine ; Biomechanical Phenomena ; Biomechanics ; Cadaver ; Edema ; Edema - etiology ; Edema - physiopathology ; Female ; Humans ; Kinematics ; Knee ; Knee Joint - physiopathology ; Male ; Medicine ; Medicine & Public Health ; Models, Anatomic ; Orthopedics ; Pain ; Patellofemoral Pain Syndrome - etiology ; Ultrasonic imaging</subject><ispartof>Archives of orthopaedic and trauma surgery, 2009-08, Vol.129 (8), p.1025-1030</ispartof><rights>Springer-Verlag 2006</rights><rights>Archives of Orthopaedic and Trauma Surgery is a copyright of Springer, (2006). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-e6324a65e15742f1294f2486878148b9614a5a9fe75a941fdd6171bf9a3654fb3</citedby><cites>FETCH-LOGICAL-c370t-e6324a65e15742f1294f2486878148b9614a5a9fe75a941fdd6171bf9a3654fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-006-0237-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-006-0237-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17053945$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bohnsack, Michael</creatorcontrib><creatorcontrib>Klages, Phillip</creatorcontrib><creatorcontrib>Hurschler, Christof</creatorcontrib><creatorcontrib>Halcour, Andre</creatorcontrib><creatorcontrib>Wilharm, Arne</creatorcontrib><creatorcontrib>Ostermeier, Sven</creatorcontrib><creatorcontrib>Rühmann, Oliver</creatorcontrib><creatorcontrib>Wirth, Carl-Joachim</creatorcontrib><title>Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis.
Materials and methods
Isokinetic knee extension from 120° of flexion to full extension was simulated on 10 human knee cadaver specimens (six males, four females, average age at death 42 years) using a knee kinemator. Joint kinematics was evaluated by ultrasound sensors (CMS 100
TM
, Zebris, Isny, Germany), and retro-patellar contact pressure was measured using a thin-film resistive ink pressure system (K-Scan
TM
4000, Tekscan, Boston). Infrapatellar tissue pressure was analyzed using a closed sensor cell which was implanted inside the fat pad (GISMA, Buggingen, Germany). An inflatable fluid cell was implanted by ultrasound control in the center of the infrapatellar fat pad and filled subsequently with water to simulate a fat pad edema. All parameters were recorded and analyzed from 0 to 5 ml volume of the fluid cell.
Results
Simulating a fat pad edema resulted in a significant (
P
< 0.01) increase of the infrapatellar fat pad pressure (247 mbar at 0 ml to 615 mbar at 5 ml volume). In knee extension and flexion the patella flexion (sagittal plane) was decreased while we did not find any other significant influence of the edema on knee kinematics. During the analysis of the patellofemoral biomechanics, a simulated fat pad edema resulted in a significant (
P
< 0.05) decrease of the patellofemoral force between 120° of knee flexion and full extension. The contact area was reduced significantly near extension (0°–30°) by an average of 10% while the contact pressure was reduced at the entire range of motion up to 20%.
Conclusion
An edema of the infrapatellar fat pad does not cause an increase of the patellofemoral pressure or a significant alteration of the patellofemoral glide mechanism. Anterior knee pain in case of a fat pad edema may be related to a significant increase of the tissue pressure and possible histochemical reactions.</description><subject>Adipose Tissue</subject><subject>Adult</subject><subject>Arthroplasty - adverse effects</subject><subject>Arthroscopy and Sports Medicine</subject><subject>Biomechanical Phenomena</subject><subject>Biomechanics</subject><subject>Cadaver</subject><subject>Edema</subject><subject>Edema - etiology</subject><subject>Edema - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Kinematics</subject><subject>Knee</subject><subject>Knee Joint - physiopathology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Models, Anatomic</subject><subject>Orthopedics</subject><subject>Pain</subject><subject>Patellofemoral Pain Syndrome - etiology</subject><subject>Ultrasonic imaging</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUFrFjEQhoMo9mv1B3iRgOBtNZNkk403KWoLBS96DtndiU27m6zJ7qH9If5e87EfFAQvCcw87zszvIS8AfYBGNMfC2OS8YYx1TAudPP4jBxACtkIA-o5OTAjVNOxFs7IeSl3jAHvDHtJzkCzVhjZHsif6-inDeOANHnqIg3RZ7e4FafJZerdShc3UhxxdjRFuneSxzllN9E-pBmHWxfDUKp6pPcRkd6HWPG11j5RR5dUSugnpBmnWqwma6LrLVZ-xRxS3kWLC5GWhzjmavmKvPBuKvj69F-Qn1-__Li8am6-f7u-_HzTDEKztUEluHSqRWi15B64kZ7LTnW6A9n1RoF0rTMedX0l-HFUoKH3xgnVSt-LC_J-911y-r1hWe0cynC8PWLailXVlindVvDdP-Bd2nKsu1nOFZg6E1SlYKeGXI_O6O2Sw-zygwVmj5HZPTJbI7PHyOxj1bw9OW_9jOOT4pRRBfgOlNqKvzA_jf6_61-tb6Mv</recordid><startdate>20090801</startdate><enddate>20090801</enddate><creator>Bohnsack, Michael</creator><creator>Klages, Phillip</creator><creator>Hurschler, Christof</creator><creator>Halcour, Andre</creator><creator>Wilharm, Arne</creator><creator>Ostermeier, Sven</creator><creator>Rühmann, Oliver</creator><creator>Wirth, Carl-Joachim</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20090801</creationdate><title>Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome</title><author>Bohnsack, Michael ; Klages, Phillip ; Hurschler, Christof ; Halcour, Andre ; Wilharm, Arne ; Ostermeier, Sven ; Rühmann, Oliver ; Wirth, Carl-Joachim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-e6324a65e15742f1294f2486878148b9614a5a9fe75a941fdd6171bf9a3654fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adipose Tissue</topic><topic>Adult</topic><topic>Arthroplasty - adverse effects</topic><topic>Arthroscopy and Sports Medicine</topic><topic>Biomechanical Phenomena</topic><topic>Biomechanics</topic><topic>Cadaver</topic><topic>Edema</topic><topic>Edema - etiology</topic><topic>Edema - physiopathology</topic><topic>Female</topic><topic>Humans</topic><topic>Kinematics</topic><topic>Knee</topic><topic>Knee Joint - physiopathology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Models, Anatomic</topic><topic>Orthopedics</topic><topic>Pain</topic><topic>Patellofemoral Pain Syndrome - etiology</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bohnsack, Michael</creatorcontrib><creatorcontrib>Klages, Phillip</creatorcontrib><creatorcontrib>Hurschler, Christof</creatorcontrib><creatorcontrib>Halcour, Andre</creatorcontrib><creatorcontrib>Wilharm, Arne</creatorcontrib><creatorcontrib>Ostermeier, Sven</creatorcontrib><creatorcontrib>Rühmann, Oliver</creatorcontrib><creatorcontrib>Wirth, Carl-Joachim</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bohnsack, Michael</au><au>Klages, Phillip</au><au>Hurschler, Christof</au><au>Halcour, Andre</au><au>Wilharm, Arne</au><au>Ostermeier, Sven</au><au>Rühmann, Oliver</au><au>Wirth, Carl-Joachim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2009-08-01</date><risdate>2009</risdate><volume>129</volume><issue>8</issue><spage>1025</spage><epage>1030</epage><pages>1025-1030</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
An edema of the infrapatellar fat pad following knee arthroscopy or in case of chronic anterior knee pain syndrome is suspected to increase the patellofemoral pressure by a modification of the patellofemoral glide mechanism. The study was performed to evaluate this hypothesis.
Materials and methods
Isokinetic knee extension from 120° of flexion to full extension was simulated on 10 human knee cadaver specimens (six males, four females, average age at death 42 years) using a knee kinemator. Joint kinematics was evaluated by ultrasound sensors (CMS 100
TM
, Zebris, Isny, Germany), and retro-patellar contact pressure was measured using a thin-film resistive ink pressure system (K-Scan
TM
4000, Tekscan, Boston). Infrapatellar tissue pressure was analyzed using a closed sensor cell which was implanted inside the fat pad (GISMA, Buggingen, Germany). An inflatable fluid cell was implanted by ultrasound control in the center of the infrapatellar fat pad and filled subsequently with water to simulate a fat pad edema. All parameters were recorded and analyzed from 0 to 5 ml volume of the fluid cell.
Results
Simulating a fat pad edema resulted in a significant (
P
< 0.01) increase of the infrapatellar fat pad pressure (247 mbar at 0 ml to 615 mbar at 5 ml volume). In knee extension and flexion the patella flexion (sagittal plane) was decreased while we did not find any other significant influence of the edema on knee kinematics. During the analysis of the patellofemoral biomechanics, a simulated fat pad edema resulted in a significant (
P
< 0.05) decrease of the patellofemoral force between 120° of knee flexion and full extension. The contact area was reduced significantly near extension (0°–30°) by an average of 10% while the contact pressure was reduced at the entire range of motion up to 20%.
Conclusion
An edema of the infrapatellar fat pad does not cause an increase of the patellofemoral pressure or a significant alteration of the patellofemoral glide mechanism. Anterior knee pain in case of a fat pad edema may be related to a significant increase of the tissue pressure and possible histochemical reactions.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>17053945</pmid><doi>10.1007/s00402-006-0237-z</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0936-8051 |
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| issn | 0936-8051 1434-3916 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adipose Tissue Adult Arthroplasty - adverse effects Arthroscopy and Sports Medicine Biomechanical Phenomena Biomechanics Cadaver Edema Edema - etiology Edema - physiopathology Female Humans Kinematics Knee Knee Joint - physiopathology Male Medicine Medicine & Public Health Models, Anatomic Orthopedics Pain Patellofemoral Pain Syndrome - etiology Ultrasonic imaging |
| title | Influence of an infrapatellar fat pad edema on patellofemoral biomechanics and knee kinematics: a possible relation to the anterior knee pain syndrome |
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