Title Page
Contents
Abstract 10
Chapter Ⅰ. Effect of proximodistal patellar malalignment on patellofemoral contact pressure 12
1.1. Introduction 12
1.2. Materials and Methods 15
1.2.1. Specimen preparation 15
1.2.2. Measurement of vertical position of patella 16
1.2.3. Group designs 19
1.2.4. Testing apparatus 21
1.2.5. Contact pressure measurement 23
1.2.6. Testing protocol 25
1.2.7. Data analysis 28
1.2.8. Statistical analysis 30
1.3. Results 31
1.3.1. Pressure area measurement 31
1.3.2. Mean pressure measurement 34
1.3.3. Peak pressure measurement 37
1.4. Discussion 40
Chapter Ⅱ. Effect of distal or craniodistal tuberosity transposition on patellofemoral contact pressure 48
2.1. Introduction 48
2.2. Materials and Methods 50
2.2.1. Specimen preparation 50
2.2.2. Measurement of patellar vertical position 51
2.2.3. Testing apparatus 54
2.2.4. Tibial tuberosity transposition 56
2.2.5. Group design 59
2.2.6. Contact pressure measurement 61
2.2.7. Testing protocol 63
2.2.8. Data analysis 64
2.2.9. Statistical analysis 66
2.3. Results 67
2.3.1. Patellofemoral contact pressure area 67
2.3.2. Mean pressure measurement 70
2.3.3. Peak pressure measurement 72
2.3.4. Medial peak pressure measurement 74
2.3.5. Lateral peak pressure measurement 77
2.4. Discussion 79
General Conclusion 85
References 86
Abstract (in Korean) 92
Table 1-1. Measurement of vertical position of the patella and transposition length of tibial tuberosity to modeling proximodistal malalignment groups 18
Table 1-2. Pressure area value under the different vertical position groups. 32
Table 1-3. Mean pressure area value under the different vertical position groups. 35
Table 1-4. Peak pressure area value under the different vertical position groups. 38
Table 2-1. Measurement of control group vertical position and length of tibial tuberosity transposition 53
Table 2-2. The pressure values under the three conditions 68
Table 2-3. The medial and lateral peak pressure values under the three conditions 75
Figure 1-1. The radiography of the cadaveric hindlimb to determine patellar vertical position. 17
Figure 1-2. The graphic images of four different vertical patellar position groups. 20
Figure 1-3. Schematic diagram of the testing frame and adjustment of stifle flexion angle. 22
Figure 1-4. The contact pressure testing system and simulation of the testing protocol. 24
Figure 1-5. The method to modeling patella alta group by proximal tibial tuberosity transposition based on measurement of vertical patellar position. 26
Figure 1-6. The example of measurement data is recorded by the software. 27
Figure 1-7. The procedure of the raw data to calibrated data spreadsheet. 29
Figure 1-8. The line graph of the pressure area value under the different vertical position groups. 33
Figure 1-9. The line graph of mean pressure value under the different vertical position groups. 36
Figure 1-10. The line graph of peak pressure value under the different vertical position groups. 39
Figure 2-1. The method of distal tibial tuberosity transposition based on measurement of vertical patellar position. 52
Figure 2-2. Testing jig to simulate the quadriceps mechanism in the phases of stance posture. 55
Figure 2-3. Distal tibial tuberosity transposition to normalize patella alta. 57
Figure 2-4. Craniodistal tibial tuberosity transposition to normalize patella alta. 58
Figure 2-5. The graphic images of three different condition groups. 60
Figure 2-6. Contact pressure testing system. 62
Figure 2-7. The example of the contact map data spreadsheet between groups. 65
Figure 2-8. Line graph of contact pressure values in three conditions. 69
Figure 2-9. Mean pressure value under three conditions. 71
Figure 2-10. Peak pressure value under three conditions. 73
Figure 2-11. Medial and lateral peak pressure values under three conditions. 76
Figure 2-12. The difference value between medial and lateral peak pressure under three conditions. 78