ArticleJournal of orthopaedic research : official publication of the Orthopaedic Research Society2025
Impact of Femoral and Tibial Torsion on Patellofemoral Loading in Individuals With Patellofemoral Instability.
Article in Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Femoral neck anteversion among five canid taxa.Anatomical record (Hoboken, N.J. : 2007) · 2026Article
- Assessment and management of torsional malalignment in paediatric patients with patellofemoral joint instability.Journal of children's orthopaedics · 2026Article
- Guide to lower extremity radiologic measurements: part 1 hip.Skeletal radiology · 2026Review
- Patellofemoral instability: Anatomy, imaging techniques, and clinically relevant measurements.Skeletal radiology · 2026Review
- Ontogenetic changes in femoral morphology and joint loads in children.Bone & joint research · 2026Article
- Article
- The Strengthening of Quadriceps, Abductors, and External Rotator Muscles of the Hip to Alter Axial Alignment of the Lower Limbs in University Students with Patellofemoral Pain Syndrome: A Prospective Cohort Study.Journal of functional morphology and kinesiology · 2026Article
- Foot progression angle modifications alter hip joint contact forces and femoral growth plate mechanics in children.Frontiers in bioengineering and biotechnology · 2026Article
- The effect of lateral hinge fracture with hinge hole and protective K-wire for medial opening-wedge high tibial osteotomy by compression testing and finite element analysis.Journal of orthopaedic surgery and research · 2025Article
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7 authors.
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Abstract
Patellofemoral stability is affected by several morphological factors including torsional alignment. To elucidate the impact of factors responsible for the stability of the patellofemoral joint, biomechanical research utilizes the analysis of joint contact forces. At present, there is a paucity of modeling-based research examining the influence of lower limb torsion on patellofemoral joint loading in individuals with patellofemoral instability. The objective of this study was to investigate the impact of the femoral version and tibial torsion on the patellofemoral joint loading. Musculoskeletal simulations were conducted based on 3D motion capture data of 40 individuals with patellofemoral instability using OpenSim. We created three models with different lower limb torsions for each participant: (i) generic torsion, (ii) personalized lower limb (femur and tibia) torsion, and (iii) isolated personalized femoral version model. We correlated femoral version and tibial torsion to differences in patellofemoral joint loading, muscle forces, and lever arms between models. Tibial torsion correlated to differences in mediolateral patellofemoral force (ρ = 0.39), whereas the femoral version showed no significant correlation to the differences in mediolateral patellofemoral force (ρ = 0.01). Notably, when neglecting individual tibial torsion, the femoral version correlated to differences in mediolateral patellofemoral force (ρ = 0.65). The femoral version can increase the lateralizing force on the patella, but this effect diminishes when addressing whole lower limb torsion in musculoskeletal simulations. Studies investigating solely the femoral version should, therefore, be interpreted with caution. Our findings underscore the necessity of evaluating whole lower limb torsion for a comprehensive assessment of its impact on patellofemoral stability and planning treatments. Level of Evidence: Retrospective cohort study, Level III.
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