Effect of the vastus medialis obliquus on the patellofemoral joint

被引：36

作者：

Taşkiran E. ^{[1
]}

Dinedurga Z. ^{[1
]}

Yaǧiz A. ^{[2
]}

Uludaǧ B. ^{[3
]}

Ertekin C. ^{[3
]}

Lök V. ^{[1
]}

机构：

[1] Dept. Orthopaedics and Traumatology, Ege University, School of Medicine, TR-35100 Bornova, Izmir

[2] Department of Physical Therapy, Ege University, School of Medicine, Bornova, Izmir

[3] Department of Neurology, Ege University, School of Medicine, Bornova, Izmir

来源：

Knee Surgery, Sports Traumatology, Arthroscopy | 1998年 / 6卷 / 3期

关键词：

Computed tomography; Electromyography; Patellofemoral joint; Quadriceps muscle; Vastus medialis obliquus;

D O I：

10.1007/s001670050095

中图分类号：

学科分类号：

摘要：

In this study, the effect of dynamic stabilizers on the patellofemoral (PF) joint was investigated in normal volunteers (group I) and in patients with patellar pain (group II) or instability (group III) by using computed tomography (CT) analysis and integrated electromyography (iEMG) of the quadriceps muscle. Nine subjects (16 knees) from group I, 10 patients (12 knees) from group II and 8 patients (12 knees) from group III were included in the study. CT scans of the PF joint with quadriceps contracted (QC) and uncontracted (QU) and iEMG of vastus medialis obliquus (VMO), vastus lateralis (VL) and rectus femoris (RF) were obtained with the aid of a specially designed jig at 0°, 15°, 30° and 45° of knee flexion. The same muscle contraction pattern simulating closed kinetic chain exercise was used for both CT and iEMG. The difference between the congruence angles (CA) and tilt angles (PTA) in QC and QU positions and VMO:VL ratio from the iEMG were calculated separately for each flexion angle. CA was increased in all groups with quadriceps contraction at 0° and 15° of flexion. PTA was decreased in group I and increased in groups II and III with quadriceps contraction at the same flexion angles. This difference was statistically significant in group III at 0° and 15° of flexion. Quadriceps contraction did not affect the patellar position significantly even in the instability group at 45° of flexion. In all flexion angles the balanced VMO:VL activity ratio was observed only in group I. In the other goups, VL activity was higher than VMO activity except at 45° of flexion. These findings do not support the hypothesis of dominant centralizing effect of VMO on the patella in extension, but the effect of the VMO may be more clearly demonstrated by measuring PTA in both QC and QU positions.

引用

页码：173 / 180

页数：7

共 43 条

[1]

Aglietti P., Ruzzi R., Insall J.N., Disorders of the patellofemoral joint, Surgery of the Knee, pp. 241-385, (1993)

[2]

Ando T., Hirose H., Inoue M., Shino K., Doi T., A new method using computed tomographic scan to measure the rectus femoris-patellar tendon Q-angle: Comparison with conventional method, Clin Orthop, 289, pp. 213-219, (1993)

[3]

Basmajian J.V., Harden T.P., Regenos E.M., Integrated actions of the four heads of quadriceps femoris

[4]

an electromyographic study, Anat Rec, 172, pp. 15-20, (1972)

[5]

Boucher J.P., King M.A., Lefebvre R., Pepin A., Quadriceps muscle activity in patellofemoral pain syndrome, Am J Sports Med, 20, pp. 527-532, (1992)

[6]

Bouisset S., Maton B., Quantitative relationship between surface EMG and intramuscular electromyographic activity in voluntary movement, Am J Phys Med, 51, pp. 285-295, (1972)

[7]

Brattstrom H., Shape of the intercondylar groove normally and in recurrent dislocation of patella: A clinical and X-ray anatomical investigation, Acta Orthop Scand, 68, pp. 134-148, (1964)

[8]

Dejour H., Walch G., Nove-Josserand L., Guier C., Factors of patellar instability: An anatomic radiographic study, Knee Surg Sports Traumatol Arthrose, 2, pp. 19-26, (1994)

[9]

Goh J.C., Lee P.Y., Bose K., A cadaver study of the function of the oblique part of vastus medialis, J Bone Joint Surg [Br], 777, pp. 225-231, (1995)

[10]

Goutailler D., Bemegau J., Lecudonnec B., Mesure de l'écart tubérosité tibiale anterieure-gorge de le trochlée (T.A.-G.T.)

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