The effect of quadriceps contraction during weight-bearing on four patellar height indices

The effect of weight-bearing on the height of the patellar using four radiological indices was studied in 25 healthy men using lateral radiographs of the knee in 30 degrees of flexion non-weight-bearing and weight-bearing. The position of the patella was quantified using the Insall-Salvati, the modified Insall-Salvati, the Blackburne-Peel and the Caton indices. The contraction of the quadriceps on weight-bearing resulted in statistically significant proximal displacement of the patella with all four indices studied. The mean Insall-Salvati index was 0.919 (SD 0.063) before and 1.109 (SD 0.042) after weight-bearing (p = 0.001), while the mean modified Insall-Salvati index was 0.734 (SD 0.039) before and 0.896 (SD 0.029) after weight-bearing (p = 0.041). Similarly, the Blackburne-Peel index was 0.691 (SD 0.09) before and 0.807 (SD 0.137) after weight-bearing (p = 0.012). The mean Caton index was 0.861 (SD 0.09) before and 0.976 (SD 0.144) after weight-bearing (p = 0.023). The effect of quadriceps contraction should be considered in clinical studies where the patellar position indices are reported.