Comparison of Q-angle at Rest and with SQE in Standing Position between Normal Person and Chondromalecia Patelle

Chondromalacia means “softening of the cartilage”, and Patellae means “the knee-cap”. So Chondromalacia patellae means “softening of the articular cartilage of the knee-cap.”

It can happen in the older age-group and in teenagers (especially girls).

Any flexion of the knee increases the tendency of the patella to dislocate. Undue pressure is placed on the lateral (outer) facet of the patella. Moreover, in many of these teenagers, the vastus lateralis and vastus medialis components are not well-balanced. The vastus lateralis tends to be more powerful than the vastus medialis, thus increasing the tendency for the patella to track or dislocate laterally. This again puts undue pressure on the lateral facet. This uneven and excessive pressure on the lateral facet leads to cartilage “softening” and breakdown. Q-angle was measured in standing. This has the advantage of measuring the Q-angle in the patient's usual upright posture, so that the normal weight bearing stresses (such as valgus stresses on the knee and internal rotation forces) are included in the measurement.

To find out the difference of Q-angle in standing with Quadricep relaxed and static quads exercise

To find out the effect of S.Q.E. on Q-angle.

Study design: cross sectional observational study. Total 30 Girls include according to selection criteria. In Group –A did not present any complaint of pain in the knees; traumatic or surgical records or any pathology involving any of the joints of the lower limbs; vascular, peripheral or central neurological disorder, constituting the group of knees considered normal- means asymptomatic.

Inclusion factors for Group-B: Anterior or retropatellar pain when performing at least two of the following activities: ascending stairs, be seat for long periods, upon squatting, kneeling, or jumping; Patella joint crepitus elicited upon palpation of extended knee or when the knee is flexed. Pain on the patellar palpation; symptoms for more than one month whose onset is not related to any trauma.

As exclusion factors were: signs or symptoms of another pathology; recent history (less than 1year) of surgery in the knees; patellar luxation or subluxation; meniscal injury; ligamentous instability; patellar tendinitis; osteoarthrosis or radiating pain in lower limb;forefoot pronation.

Group-A-15 Asymptomatic girls between 20–30 years

Group-B-15 Girls between 20–30 years who has CMP. Subjects were instructed to stand with their feet shoulder width apart and parallel to each other with their weight evenly distributed over both feet. For the SQE- subjects were simply told to produce a strong quadriceps contraction and hold it for 5 seconds.

Q- angle was measured first with quadriceps relaxed in standing position and then teach the person S.Q.E. in standing and Q-angle was measured.

Angle was measured by long arm Goniometer by marking from ASIS to midpoint of patellae and midpoint of patellae to tibial tuberocity and analysis done by using student t test.

Result showed significant difference in normal group (1.533 ± 1.30) p<0.01 and in CMP group(4.333±1.915), p<0.001 highly significant.

At the end of study we conclude that in Chondromalesia patelle Q-angle is more as compare to normal in standing position and with static quads exercise angle was reduce. So, SQE has positive effect to reduced Q-angle and correct patellar malalignment