Altered Hip Mechanics and Patellofemoral Pain. A Review of Literature

Abstract

Patellofemoral pain (PFP) is a common knee disorder in orthopedic clinics. In the last decade, several investigations have considered the role of proximal factors in addition to local and distal factors in development of PFP. There is a hypothesis which suggests that impaired neuromuscular control and altered hip joint kinematic affect tibiofemoral and patellofemoral biomechanics. Hence, PFP may develop as a result. This article reviews studies assessing the relationship between altered hip mechanics and PFP. The Medline and PubMed databases were searched between January 2004 and October 2014. Two authors independently selected related articles using the same search strategy and key words. Among 149 articles, 16 met the review inclusion criteria. The study results were described in three sections: 1) kinematic studies, 2) muscle activity studies, and 3) postural stability studies. Increased hip adduction and internal rotation, gluteal muscle weakness, and neuromuscular impairment were common findings in patients with patellofemoral pain. Precise assessment of hip mechanics, including hip kinematic, muscle performance and postural stability, should be considered in the examination of patients with patellofemoral pain.