Association between Q angle and predisposition to gonarthrosis*

Year 2017, Volume: 11 Issue: 1, 21 - 25, 30.04.2017

Fatma Havaslı Mehmet Demir , Mustafa Çiçek Atilla Yoldaş

Abstract

Objectives: The aim of our study was to evaluate the relationship between quadriceps angle (Q angle), body mass index (BMI), dominant side and pain severity in gonarthrosis patients.

Methods: In order to determine the Q angle in gonarthrosis patients, 205 volunteer patients (104 men and 101 women) diagnosed with gonarthrosis and 110 control subjects (60 men and 50 women) over 40 years of age were included. In the patient group, sides with pain, pain levels, right and left leg Q angle values, and dominant sides were evaluated.

Results: Right Q angle value was found 13.21°±3.22° in patients and 13.26°±2.04° in controls, while the left Q values were 12.86°±3.35° and 12.65°±2.52° in patients and controls, respectively. No significant difference was found between the right and left Q angles both for patients (p=0.885) and controls (p=0.568). When the pain levels and right Q angles of the patients were compared, a positive correlation between the Q angle elevation and increase in pain was found (p=0.001). In addition, the pain level increase and left Q angle elevation of the patients were also found positively correlated (p=0.004).

Conclusion: The results of this study show that measuring the Q angle, despite its low sensitivity and internal consistency levels, is an effective way of diagnosing and treating the lower extremity malalignments and related pathologies.

Keywords

dominant side, gonarthrosis, pain severity, Q angle

References

• 1. Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 2000;133:635–46.
• 2. Atay MB, Beyazova M, Gökçe KY. Osteoartrit. Fiziksel tıp ve rehabilitasyon. Ankara: Güneş Kitabevi; 2011. s. 2533–63.
• 3. Olcay E, Çetinus E , Mert M, Kara AN. Genç erkek ve bayanlarda ayakta ve yatar pozisyonlarda quadriceps açısının mukayesesi ve değerlendirilmesi. Acta Orthop Traumatol Turc 1994;28:25–7.
• 4. Livingston LA, Spaulding SJ. OPTOTRAK measurement of the quadriceps angle using standardized foot positions. J Athl Train 2002; 37:252–5.
• 5. Toraman F, Yaman H, Taşralı S. Patellofemoral açı farklılığının alt ekstremite performansı üzerine etkisi. Totbid Dergisi 2003;14:13–7.
• 6. Powers C. The influence of altered lower- extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003;33:639–46.
• 7. Horton M, Hall T. Quadriceps femoris muscle angle: normal values and relationships with gender and selected skeletal measures. Phys Ther 1989;69:897–901.
• 8. Greene CC, Edwards TB, Wade MR, Carson EW. Reliability of the quadriceps angle measurement. Am J Knee Surg 2001;14:97–103.
• 9. Schulthies S, Francis R, Fisher A, Graaff K, Van de Graaff KM. Does the Q angle reflect the force on the patella in the frontal plane? Phys Ther 1995;75:24–30.
• 10. Livingston LA, Mandigo JL. Bilateral Q angle asymmetry and anterior knee pain syndrome. Clin Biomech (Bristol, Avon) 1999;14:7–13.
• 11. McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med 1988;18:1007– 19.
• 12. Weiss L, DeForest B, Hammond K, Schilling B, Ferreira L. Reliability of goniometry-based Q-angle. PM R 2013;5:763–8.
• 13. France L, Nester C. Effect of errors in the identification of anatomical landmarks on the accuracy of Q angle values. Clin Biomech (Bristol, Avon) 2001;16:710–3.
• 14. Livingston L, Mandigo J. Bilateral within-subject Q angle asymmetry in young adult females and males. Biomed Sci Instrum 1997;33:112–7.
• 15. Denizoğlu H. Sağlıklı bireylerde Q açısı ile denge arasındaki ilişki. Abant İzzet Baysal Üniversitesi Sağlık Bilimleri Enstitüsü Fizik Tedavi ve Rehabilitasyon Program› Yüksek Lisans Tezi, Bolu, 2010.
• 16. Byl T, Cole JA, Livingston L. What determines the magnitude of the Q angle? A preliminary study of select skeletal and muscular measures. Journal of Sport Rehabilitation 2000;9:26–34.
• 17. Yercan HS, Taşkıran H. Patellofemoral eklem patolojisi ile alt ekstremite torsiyonel deformitelerin ilişkisi. Eklem Hastalıkları Cerrahisi Dergisi 2004;2:71–5.
• 18. Bayraktar B, Yucesir I, Ozturk A, Cakmak A, Taşkara N, Kale A, Demiryurek D, Bayramoglu A, Camlica H. Change of quadriceps angle values with age and activity. Saudi Med J 2004; 25:756–60.
• 19. Hsu RW, Himeno S, Coventry MB, Chao EY. Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 1990;(255):215–27.
• 20. Kalpakçıoğlu A, Çakmak B. Bahadır C. Diz osteoartritinde ultrason ve kısa dalga diatermi tedavilerinin karşılaştırması. Türk Fiziksel Tıp ve Rehabilitasyon Dergisi 2006;52:168–73.
• 21. Manek NJ, Hart D, Spector TD, MacGregor AJ. The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis Rheum 2003;48: 1024–9.
• 22. Skalley TC, Terry GC, Teitge RA. The quantitative measurement of normal passive medial and lateral patellar motion limits. Am J Sports Med 1993;21:728–32.