Neuromechanics of the patellofemoral joint

Patellofemoral joint pain is one of the most common ailments associated with visits to sports medicine clinics and can be disabling, although conservative clinical treatment has a reportedly very high success rate. Patellofemoral joint pain is often associated with improper tracking of the patella within the femoral trochlear notch. Improper tracking of the patella can be associated with increased patellofemoral contact pressures that may be a mechanical stimulus underlying patellar cartilage degeneration. In those cases in which anatomic anomalies and trauma may be excluded as the basis for improper tracking, attention is directed toward possible disruptions to the central nervous system control and contractile potential of the knee joint extensor musculature that underlies proper patellofemoral mechanics. This paper presents a review of three seminal components related to the neuromechanics of patellofemoral function; patellofemoral tracking, patellofemoral contact pressures, and neuromotor control of patellofemoral agonists. It is the intent of the authors to illuminate areas requiring further basic and clinical research and provide a point of departure for this work.