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First published on May 18, 2004, doi:10.1177/0363546503262693
This version was published on July 1, 2004
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The American Journal of Sports Medicine 32:1209-1217 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Active Patellar Tracking Measurement

A Novel Device Using Ultrasound

Yi-Fen Shih, PhD*, Anthony M. J. Bull, PhD{dagger}, Alison H. McGregor, PhD{ddagger} and Andrew A. Amis, DSc*,{ddagger},§

From the * Department of Mechanical Engineering, Imperial College, London, England, the {dagger} Department of Bioengineering, Imperial College, London, England, and the {ddagger} Department of Musculoskeletal Surgery, Imperial College, London, England

§ Address correspondence to Professor Andrew A. Amis, Biomechanics Section, Mechanical Engineering Department, Room 638, Mechanical Engineering Building, South Kensington Campus, Imperial College, London, England SW7 2AZ (e-mail: a.amis{at}imperial.ac.uk).

Background: Many patients suffer patellar instability that may relate to transient patellar tracking abnormalities.

Objective: To develop and test a technique to measure dynamic patellar tracking.

Study Design: Controlled laboratory and in vivo study.

Method: A functional knee brace was modified to allow an ultrasound transducer to be mounted laterally to the femur, following the path of the patella during knee movement. An ultrasound system was used to measure patellar mediolateral position parallel to the femoral transepicondylar axis. Ten subjects with no patellar instability were studied to obtain patellar tracking and accuracy data.

Results: The interobserver and intraobserver reproducibility ranged from 0.2 ± 0.1 mm to 1.0 ± 0.5 mm. The accuracy of the ultrasound measurement was checked against magnetic resonance imaging and was 0.6 ± 1.9 mm. The patella moved medially then laterally from extension to flexion when sitting. Squatting and stepping produced a more lateral path, without the initial medial translation. The patella was more lateral during knee extension than during flexion.

Conclusions: This novel method for measurement of dynamic patellar mediolateral tracking was found to have good intraobserver and interobserver reproducibility, and the measurements matched closely with those obtained from magnetic resonance imaging reconstructions of static patellar positions. Some preliminary data for tracking in 3 activities were obtained from 10 normal knees.

Key Words: patella • patellofemoral joint • patellar tracking • ultrasound • kinematics






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