Vasti Control of Patellofemoral Kinematics in Asymptomatic Volunteer
| Status: | Completed |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 18 - 55 |
| Updated: | 4/6/2019 |
| Start Date: | August 26, 2009 |
Vasti Control of Patellofemoral Kinematics in Patellofemoral Pain Syndrome
Background:
- Patellofemoral pain syndrome is one of the most common knee problems. It is
characterized by pain in the front of the knee that is aggravated by deep knee flexion,
prolonged sitting, and repetitive movement. The most widely accepted theory regarding
the source of this pain is that a force imbalance around the knee puts extra stress on
the area, leading to pain.
- Researchers are interested in learning more about the muscle groups around the knee to
better understand the causes of knee pain.
Objectives:
- To obtain more information on how muscles, tendons, and bones work together to cause motion
in the knee, both in the normal state and after immobilizing certain muscles around the knee.
Eligibility:
- Healthy individuals between the ages of 18 and 55, who have no current or chronic muscle,
bone, or joint problems and who have no implants or other problems that would prevent them
from receiving a magnetic resonance imaging (MRI) scan.
Design:
- This protocol will be carried out over two visits, both of which will involve using
standard MRI sequences to look at the knee at rest and in motion.
- The first part will examine the knee under its natural state, with a standard MRI scan
of the knee both at rest and in motion.
- The second part will involve temporarily reducing the force producing capabilities of
one of the extensor muscles in the knee. To do so, study doctors will inject lidocaine
into the muscle, which will temporarily (for approximately 2 hours) block the force
producing capacity of this muscle, and then perform the MRI scan....
- Patellofemoral pain syndrome is one of the most common knee problems. It is
characterized by pain in the front of the knee that is aggravated by deep knee flexion,
prolonged sitting, and repetitive movement. The most widely accepted theory regarding
the source of this pain is that a force imbalance around the knee puts extra stress on
the area, leading to pain.
- Researchers are interested in learning more about the muscle groups around the knee to
better understand the causes of knee pain.
Objectives:
- To obtain more information on how muscles, tendons, and bones work together to cause motion
in the knee, both in the normal state and after immobilizing certain muscles around the knee.
Eligibility:
- Healthy individuals between the ages of 18 and 55, who have no current or chronic muscle,
bone, or joint problems and who have no implants or other problems that would prevent them
from receiving a magnetic resonance imaging (MRI) scan.
Design:
- This protocol will be carried out over two visits, both of which will involve using
standard MRI sequences to look at the knee at rest and in motion.
- The first part will examine the knee under its natural state, with a standard MRI scan
of the knee both at rest and in motion.
- The second part will involve temporarily reducing the force producing capabilities of
one of the extensor muscles in the knee. To do so, study doctors will inject lidocaine
into the muscle, which will temporarily (for approximately 2 hours) block the force
producing capacity of this muscle, and then perform the MRI scan....
Patellofemoral pain syndrome is one of the most common problems of the knee. It is
characterized by anterior knee pain that is aggravated by deep knee flexion, prolonged
sitting, and repetitive flexion/extension. The most widely accepted theory in regards to the
source of this pain is that a force imbalance around the knee leads to static patellofemoral
malalignment and dynamic patellofemoral maltracking. In turn, this malalignment and
maltracking lead to elevated joint contact stresses, which ultimately leads to patellofemoral
pain. Current understanding of patellofemroal maltracking is typically focused on static 2D
alignment (lateral tilt and displacement). Yet, patellofemoreal pain is most often
exacerbated during dynamic events and the patella has complete six degrees of freedom in its
movement. More recent studies have been able to quantify patellofemoral kinematics during
volitional dynamic tasks and demonstrate that the maltracking problem is more complex than
originally postulated. Specifically, in patients with patellofemoral pain, altered kinematics
are not limited to excessive patellar lateral translation and tilt, but include excessive
patellar superior translation along with excessive flexion and varus rotation. Although these
results are useful in demonstrating how specific maltracking patterns could lead to
patellofemoral pain, they do not present any associations between a potentially altered force
balance around the knee and the observed maltracking patterns. Therefore, the overall goal of
this work is to determine the specific sources of maltracking patterns in patellofemoral
pain. As part of this overall goal, the purpose of this study is to determine how the loss of
force in the vasti medialis muscle alters the dynamic control of patellar kinematics.
characterized by anterior knee pain that is aggravated by deep knee flexion, prolonged
sitting, and repetitive flexion/extension. The most widely accepted theory in regards to the
source of this pain is that a force imbalance around the knee leads to static patellofemoral
malalignment and dynamic patellofemoral maltracking. In turn, this malalignment and
maltracking lead to elevated joint contact stresses, which ultimately leads to patellofemoral
pain. Current understanding of patellofemroal maltracking is typically focused on static 2D
alignment (lateral tilt and displacement). Yet, patellofemoreal pain is most often
exacerbated during dynamic events and the patella has complete six degrees of freedom in its
movement. More recent studies have been able to quantify patellofemoral kinematics during
volitional dynamic tasks and demonstrate that the maltracking problem is more complex than
originally postulated. Specifically, in patients with patellofemoral pain, altered kinematics
are not limited to excessive patellar lateral translation and tilt, but include excessive
patellar superior translation along with excessive flexion and varus rotation. Although these
results are useful in demonstrating how specific maltracking patterns could lead to
patellofemoral pain, they do not present any associations between a potentially altered force
balance around the knee and the observed maltracking patterns. Therefore, the overall goal of
this work is to determine the specific sources of maltracking patterns in patellofemoral
pain. As part of this overall goal, the purpose of this study is to determine how the loss of
force in the vasti medialis muscle alters the dynamic control of patellar kinematics.
- INCLUSION CRITERIA:
1. Healthy male and female volunteers between the ages of 18 and 55.
EXCLUSION CRITERIA:
1. Any relevant medical problems (connective tissue problems, active arthritis, etc.)
2. Any clinical signs of a knee impairment in the joint being studied, including abnormal
range of motion, muscle weakness, malaligment, and ligament damage.
3. Any serious injury to the joint being studied, previous surgery on the joint being
studied or extreme pain at the joint being studied.
4. Allergy/hypersensitivity to lidocaine.
5. Liver disease.
6. Open angle glaucoma.
7. Cardiac arrhythmias, congenital heart disease.
8. G6PD.
9. Any female who is pregnant.
A volunteer will be excluded if they have a contraindication to MR imaging. Examples
include:
1. Metal within their body, which might be expected to concentrate radiofrequency fields
or cause tissue damage from twisting in a magnetic field (e.g., aneurysm clip,
implanted neural stimulator, implanted cardiac pacemaker or autodefibrillator,
cochlear implant, ccular foreign body (e.g. metal shavings, insulin pump).
2. A condition, which would preclude them from participating in an MR imaging study
(e.g., paralyzed hemidiaphragm, morbid obesity, severe claustrophobia).
3. A condition that presents an unnecessary risk to them or their unborn child (e.g.,
pregnancy, previous surgery of uncertain type, symptoms of pheochromocytoma or
insulinoma).
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Bethesda, Maryland 20892
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