Frontal plane biomechanics during single-leg squat and hip strength in patients with isolated patellofemoral osteoarthritis compared to matched controls: A cross-sectional study

PLoS One. 2022 Apr 27;17(4):e0267446. doi: 10.1371/journal.pone.0267446. eCollection 2022.

Abstract

The patellofemoral compartment of the knee is the most frequently affected by osteoarthritis. However, there is a lack of biomechanics studies on patellofemoral osteoarthritis (PFOA). This study's purpose was to compare the frontal plane biomechanics of the trunk and lower limb during the single-leg squat and isometric hip abductor torque in individuals with isolated PFOA and controls. Frontal plane kinematics during the single-leg squat were evaluated using a three-dimensional (3-D) motion analysis system. Isometric hip abductor torque was determined using a handheld dynamometer. Twenty individuals participated in the study (10 with PFOA and 10 controls). No significant differences between groups were found regarding age (mean ± SD, PFOA group = 51.8 ± 6.9 versus control group = 47.8 ± 5.5; mean difference = 4, 95% confidence interval [CI] = -1.9 to 9.9, p = 0.20) or body mass index (PFOA group = 27.6 ± 2.2 versus control group = 25.5 ± 2.5; mean difference = 2.1, 95% confidence interval [CI] = -0.1 to 4.3, p = 0.06). Compared to control, the PFOA group presented greater hip adduction in the descending and ascending phases of the single-leg squat at 45° (mean difference [95% CI] = 6.44° [0.39-12.48°], p = 0.04; mean difference [95% CI] = 5.33° [0.24-10.42°], p = 0.045, respectively) and 60° (mean difference [95% CI] = 8.44° [2.15-14.73°], p = 0.01; mean difference [95% CI] = 7.58° [2.1-13.06°], p = 0.009, respectively) of knee flexion. No significant differences between groups were found for the frontal plane kinematics of the trunk, pelvis or knee (p > 0.05). The PFOA group exhibited lower isometric hip abductor torque (mean difference [95% CI] = -0.34 Nm/kg [-0.67 to -0.01 Nm/kg], p = 0.04). The individuals with PFOA presented greater hip adduction than the control group, which could increase lateral patellofemoral joint stress at 45° and 60° of knee flexion in the descending and ascending phases of the single-leg squat. These individuals also exhibited hip abductor weakness in comparison to healthy controls.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Humans
  • Leg*
  • Muscle Strength
  • Osteoarthritis, Knee*

Grants and funding

AFM, CC - Finance Code 001 - Coordenacão de Aperfeicoamento de Pessoal de Nıvel Superior (www.capes.gov.br). CC - grant #2017/20057-8 - São Paulo Research Foundation (www.fapesp.br). GKP - grant #2017/25959-0 - São Paulo Research Foundation (www.fapesp.br). PRMSS - grant #2018/10329-3- São Paulo Research Foundation (www.fapesp.br). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.