[Mediolateral quadriceps imbalance and peripatellar pain syndrome]

In cases of spontaneously occurring patellar pain, there is generally some slight damage to the nerve roots and anterior horn cells of segments L3 and L4. Divergent patellar movement can be measured roentgenologically. When the quadriceps is contracted the patella normally medialward in varus joints, and lateralward in valgus joints and when the leg position is axially correct. In peripatellar pain syndrome, however, lateral movement can be demonstrated in varus joints. Additionally, there is a tendency for the rotation of the patella to depend on the innervation disorder. The discrepancy between the muscular guidance of the patella and the performed guide bed may be one of the factors causing patellar pain. Etiologically, axial malpositions of the leg appear to be important predisposing factors and innervation disorders of the quadriceps muscle realization factors.