Abnormal patellar sagittal spatial kinematics in patients with patellofemoral pain: an in vivo dynamic CT study
Related Experiment Video
Updated: Aug 2, 2026
Four-Dimensional CT Analysis Using Sequential 3D-3D Registration
Published on: November 23, 2019
Mao Yuan1, Yurou Chen2, Jia Li1
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400000, PR China.
Background:
Patellofemoral joint kinematics is a complex three-dimensional(3D) motion, involving shift and rotation in the coronal, sagittal, and axial directions. Quantifying patellar tracking only at the axial level of the patella or with two-dimensional(2D) parameters may not be comprehensive. The current study sought to explore the spatial kinematics characteristics of the patella in three directions, especially the sagittal plane in patients with patellofemoral pain (PFP) based on Four-dimensional computed tomography (4D-CT).
Methods:
A total of 35 knees with PFP and 35 controls from March 2023 to May 2024 were evaluated. 3D shift and tilt of the patella were measured in the patellofemoral joint coordinate system established by MIMICS. The 3D shift and tilt of the patella in three directions (coronal, sagittal, and axial) were evaluated. Differences between groups were analyzed using two-way repeated measures ANOVA.
Results:
The 3D tiltsagittal and 3D tiltaxial trends differed between the two groups (P = 0.020, 0.018, respectively). The 3D shiftsagittal at knee flexions of 50° to 70° was significantly increased in the PFP group compared to the control group (P = 0.009, 0.015, respectively). The 3D tiltsagittal was significantly greater in the PFP group than in the control group at -10° to 10° and 50° to 70° of knee flexion (P = 0.004, 0.005, 0.046, 0.007, respectively). The 3D tiltaxial was significantly greater in the PFP group than in the control group at -10° to 0° and 40° to 70° of knee flexion (P = 0.033, 0.011, 0.004, 0.015, respectively). The 3D shiftcoronal at knee flexions of -10° to 20° were significantly decreased in the PFP group compared to the control group (P = 0.002, < 0.001, 0.018, respectively).
Conclusion:
It is necessary to evaluate the spatial position characteristics of the patellofemoral joint and the stability of the patella from multiple planes and angles at the dynamic level. Analyzing the spatial multi-plane kinematic characteristics of the patellofemoral joint may help in determining the etiology of PFP.
