Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain
<b>Background/Objectives</b>: Patellofemoral pain (PFP) is believed to be a precursor to knee osteoarthritis (OA). The primary purpose of this study was to compare matrix metalloproteinase-9 (MMP-9) levels in young adult females with and without PFP. The secondary purpose was to determin...
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MDPI AG
2025-03-01
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| author | Lori A. Bolgla Sharad Purohit Daniel C. Hannah David Monte Hunter |
| author_facet | Lori A. Bolgla Sharad Purohit Daniel C. Hannah David Monte Hunter |
| author_sort | Lori A. Bolgla |
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| description | <b>Background/Objectives</b>: Patellofemoral pain (PFP) is believed to be a precursor to knee osteoarthritis (OA). The primary purpose of this study was to compare matrix metalloproteinase-9 (MMP-9) levels in young adult females with and without PFP. The secondary purpose was to determine the associations between MMP-9, patella position, hip and knee kinematics, and pain in females with PFP. <b>Methods</b>: Plasma was analyzed for MMP-9. Patellar position was measured using diagnostic ultrasound as the degree of offset (RAB angle) from the deepest aspect of the femoral trochlear groove to the inferior pole of the patella. A positive RAB angle suggested patella lateralization. Hip and knee kinematics during a single-leg squat were measured using 2-dimensional motion analysis and quantified as the dynamic valgus index (DVI), a combined measure of hip and knee motion. A higher DVI suggests increased valgus loading at the patellofemoral joint. Pain was measured using a 10 cm visual analog scale. <b>Results</b>: Females with PFP had significantly higher levels of MMP-9 than controls (72.7 vs. 58.0 ng/mL, <i>p</i> = 0.03). Females with PFP had a significant positive association between MMP-9 and patella lateralization (<i>r</i> = 0.38, <i>p</i> = 0.04), suggesting that greater patellar lateralization may contribute to increased joint inflammation. A significant inverse association was observed between MMP-9 and the DVI (<i>r</i> = −0.50, <i>p</i> = 0.007), indicating that individuals with higher inflammatory marker levels may adopt movement patterns that reduce valgus loading. <b>Conclusions</b>: The significant association between MMP-9 and patella lateralization suggested a potential link between patella alignment and joint inflammation, which may contribute to early joint degeneration. The inverse association between MMP-9 levels and the DVI suggested that subjects with higher MMP-9 levels adjusted their movement pattern as a compensatory mechanism to reduce knee valgus stress to reduce joint degeneration. |
| format | Article |
| id | doaj-art-1c0fe8eeb73049569470bb56d50ce0f8 |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-1c0fe8eeb73049569470bb56d50ce0f82025-08-20T03:43:34ZengMDPI AGBiomedicines2227-90592025-03-0113376110.3390/biomedicines13030761Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and PainLori A. Bolgla0Sharad Purohit1Daniel C. Hannah2David Monte Hunter3Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USACenter for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA 30912, USADepartment of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USADepartment of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA<b>Background/Objectives</b>: Patellofemoral pain (PFP) is believed to be a precursor to knee osteoarthritis (OA). The primary purpose of this study was to compare matrix metalloproteinase-9 (MMP-9) levels in young adult females with and without PFP. The secondary purpose was to determine the associations between MMP-9, patella position, hip and knee kinematics, and pain in females with PFP. <b>Methods</b>: Plasma was analyzed for MMP-9. Patellar position was measured using diagnostic ultrasound as the degree of offset (RAB angle) from the deepest aspect of the femoral trochlear groove to the inferior pole of the patella. A positive RAB angle suggested patella lateralization. Hip and knee kinematics during a single-leg squat were measured using 2-dimensional motion analysis and quantified as the dynamic valgus index (DVI), a combined measure of hip and knee motion. A higher DVI suggests increased valgus loading at the patellofemoral joint. Pain was measured using a 10 cm visual analog scale. <b>Results</b>: Females with PFP had significantly higher levels of MMP-9 than controls (72.7 vs. 58.0 ng/mL, <i>p</i> = 0.03). Females with PFP had a significant positive association between MMP-9 and patella lateralization (<i>r</i> = 0.38, <i>p</i> = 0.04), suggesting that greater patellar lateralization may contribute to increased joint inflammation. A significant inverse association was observed between MMP-9 and the DVI (<i>r</i> = −0.50, <i>p</i> = 0.007), indicating that individuals with higher inflammatory marker levels may adopt movement patterns that reduce valgus loading. <b>Conclusions</b>: The significant association between MMP-9 and patella lateralization suggested a potential link between patella alignment and joint inflammation, which may contribute to early joint degeneration. The inverse association between MMP-9 levels and the DVI suggested that subjects with higher MMP-9 levels adjusted their movement pattern as a compensatory mechanism to reduce knee valgus stress to reduce joint degeneration.https://www.mdpi.com/2227-9059/13/3/761matrix metalloproteinase-9anterior knee painosteoarthritis |
| spellingShingle | Lori A. Bolgla Sharad Purohit Daniel C. Hannah David Monte Hunter Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain Biomedicines matrix metalloproteinase-9 anterior knee pain osteoarthritis |
| title | Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain |
| title_full | Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain |
| title_fullStr | Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain |
| title_full_unstemmed | Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain |
| title_short | Comparison of Inflammatory Biomarkers in Females with and Without Patellofemoral Pain and Associations with Patella Position, Hip and Knee Kinematics, and Pain |
| title_sort | comparison of inflammatory biomarkers in females with and without patellofemoral pain and associations with patella position hip and knee kinematics and pain |
| topic | matrix metalloproteinase-9 anterior knee pain osteoarthritis |
| url | https://www.mdpi.com/2227-9059/13/3/761 |
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