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An angle greater than 25 degrees between the patellar tendon and quadriceps muscle can predispose a person to patellar dislocation. [11] In patella alta, the patella sits higher on the knee than normal. [11] Normal function of the VMO muscle (VMO) stabilizes the patella. Decreased VMO function results in instability of the patella.
The normal knee flexion is between 130 and 150 degrees. Any pain, abnormal movement, or crepitus of the patella should be noted. If there is pain or crepitus during active extension of the knee, while the patella is being compressed against the patellofemoral groove, patellofemoral pain syndrome or chondromalacia patellae should be suspected ...
The patellar reflex, also called the knee reflex or knee-jerk, is a stretch reflex which tests the L2, L3, and L4 segments of the spinal cord. Many animals, most significantly humans, have been seen to have the patellar reflex, including dogs, cats, horses, and other mammalian species.
Malalignment of the patella or abnormal patellar tracking as it moves through the femoral groove. [7] People with genu valgum have larger than normal Q-angles causing the weight-bearing line to fall lateral to the centre of the knee causing overstretching of the MCL and stressing the lateral meniscus and cartilages. [citation needed]
A patella alta is a high-riding (superiorly aligned) patella. An attenuated patella alta is an unusually small patella that develops out of and above the joint. A patella baja is a low-riding patella. A long-standing patella baja may result in extensor dysfunction. [5] Insall-Salvati ratio (A divided by B). [6]
Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas
On a normal radiograph, the line intersects the inferior pole of the patella, and so can be useful in diagnosing a broken femur as well as a patellar tendon rupture. It also helps to define "Schottle point" intra-operatively for reconstruction of MPFL(Medial patello-femoral ligament.) [3] It may also be used to describe the course of an ACL graft.
Image showing how Q-angle is measured. The degree of genu valgum can clinically be estimated by the Q angle, which is the angle formed by a line drawn from the anterior superior iliac spine through the center of the patella and a line drawn from the center of the patella to the center of the tibial tubercle. In women, the Q angle should be less ...