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Load-deformation characteristics of cadaver patellae: Relationship to intraosseous pressure

      Highlights

      • Some patellofemoral pain arises in the patella.
      • Elevated patella intraosseous pressure has been correlated to pain.
      • Patellae compress elastically under physiologic loads.
      • Patella compression raises intraosseous pressure.

      Abstract

      Background

      Anterior knee pain can arise from several sources. One of the main sources of pain in patients with anterior knee pain is the patella. Increased patellofemoral joint loading is the prime source of patellar pain. Elevated intraosseous pressures have been measured in painful patellae and increasing the intraosseous fluid pressure in the patella causes pain. Whether elevated fluid pressure is an independent source of pain or if the patellar deformation under load leads to elevated pressure and pain has not been determined. Our hypothesis was that the patella deforms measurably under physiologic loads and that intraosseous pressure increase is related to that deformation. The relationship may be linear as measured by correlation or nonlinear as measured by the sum of squared error.

      Methods

      Part I: Assessment of patellar load-deformation profiles were obtained in 2 intact cadaver patellae and 1 bisected patella under physiologic loads.
      Part II: Measurements of intraosseous pressure were obtained in 9 cadaver patellae as the patellae were compressed with physiologic loads. Pressures were recorded at sequential levels of anterior-posterior patellar compression.

      Findings

      Cadaver patellae compress up to 3.5 mm in the anterior-posterior plane. Compression with physiologic forces raises intraosseous pressure to more than 40 mmHg.

      Interpretation

      Load-deformation of cadaver patellae results in deformation and an increase in intraosseous pressure. These findings may help explain previous studies of patellofemoral pain where elevated patellar intraosseous pressures have been found in vivo.

      Keywords

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