Quantification of patellofemoral joint reaction forces during functional activities using a subject-specific three-dimensional model.

The purpose of this study was to describe an imaging based, subject specific model that was developed to quantify patellofemoral joint reaction forces (PFJRF's). The secondary purpose was to test the model in a group of healthy individuals while performing various functional tasks. Twenty healthy subjects (10 males, 10 females) were recruited. All participants underwent two phases of data collection: 1) magnetic resonance imaging of the knee, patellofemoral joint, and thigh, and 2) kinematic, kinetic and EMG analysis during walking, running, stair ascent, and stair descent. Using data obtained from MRI, a subject specific representation of the extensor mechanism was created. Individual gait data were used to drive the model (via an optimization routine) and three-dimensional vasti muscle forces and subsequent three-dimensional PFJRF's were computed. The average peak PFJRF was found to be highest during running (58.2 N/kg-bwt), followed by stair ascent (33.9 N/kg-bwt), stair descent (27.9 N/kg-bwt), and walking (10.1 N/kg-bwt). No differences were found between males and females. For all conditions, the direction of the PFJRF was always in the posterior, superior, and lateral directions. The posterior component of the PFJRF always had the greatest magnitude, followed by superior and lateral components. Our results indicate that estimates of the magnitude and direction of the PFJRF during functional tasks can be obtained using a 3D-imaging based model.