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. 2024 Feb 28;11(1):e12009.
doi: 10.1002/jeo2.12009. eCollection 2024 Jan.

Impaired hemodynamics of the patella in patients with patellofemoral pain: A case-control study

Martin J Ophey  1   2   3 , Anne Westerweel  4 , Maxime van Oort  4 , Robert van den Berg  3   5   6 , Gino M M J Kerkhoffs  2   7   8 , Igor J R Tak  3   7   8   9
Affiliations

Impaired hemodynamics of the patella in patients with patellofemoral pain: A case-control study

Martin J Ophey et al. J Exp Orthop. .

Abstract

Purpose: According to the homeostasis model, patellofemoral pain (PFP) arises as a consequence of disturbed homeostasis of anterior structures of the knee due to vascular insufficiency. Near-infrared spectroscopy (NIRS) allows to measure changes of concentrations (µmol/cm2) of (de)-oxygenated hemoglobine (HHb and O2Hb). The aim was to study differences in patellar hemodynamics between patients and healthy controls.

Methods: Hemodynamics of patients (n = 30 [female = 20, age = 21.5, BMI = 22.9]) and controls (n = 30 (female = 18, age = 21.4, BMI = 22.4]) were evaluated for two activities ('Prolonged Sitting' and 'Stair Descent'). Blinding for health status was implemented.

Results: During 'Prolonged Sitting', PFP patients exhibited smaller decreases in mean changes for HHb (PFP [M = -1.5 to -1.9], healthy controls [M = -2.0 to -2.3]) and O2Hb (PFP [M = -2.0 to -3.2], healthy controls [M = -3.4 to -4.1]). However, these differences were statistically non-significant (p = 0.14-0.82 and p = 0.056-0.18, respectively). Conversely, for 'Stair Descent', PFP patients showed statistically significant smaller decreases in mean changes for HHb (PFP [M = -1.9, SD = 1.8], healthy controls [M = -2.5, SD = 1.7], p = 0.043) and O2Hb (PFP [M = -3.2, SD = 3.2], healthy controls [M = -4.9, SD = 2.7], p = 0.004).

Conclusions: The differences suggest potential impairment in patellar hemodynamics in PFP patients, providing support for the homeostasis model. Evidence-based treatment strategies targeting patellar hemodynamics should be further refined and subjected to evaluation in clinical trials.

Level of evidence: Level III.

Keywords: near‐infrared spectroscopy; patellofemoral pain.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) Activity 1 ‘Prolonged Sitting’ and (b) activity 2 ‘Stair Descent’ (absence of the opaque cloth to visualise the set‐up, during measurements the sensor was covered).
Figure 2
Figure 2
(a) Assessment of lower limb range of motion of knee flexion and (b) hip adduction (Ophey and colleagues).
Figure 3
Figure 3
Flowchart of the inclusion process.
Figure 4
Figure 4
Plotted means of HHb and O2Hb (in µmol/cm2) during Activity 1 ‘Prolonged Sitting’ and Activity 2 ‘Stair Descent’. (A) baseline (3 min); (B) ‘Prolonged Sitting’ (30 min) or ‘Stair Descent’ (1 min), respectively; (C) recovery time after ‘Prolonged Sitting’ (5 min). HHb, deoxygenated hemoglobine; m, min; O2Hb, oxygenated hemoglobine.
Figure 5
Figure 5
VAS during activity 1 ‘Prolonged Sitting’.
See this image and copyright information in PMC

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