Citation Information :
Sharma C, Ali S, Victor R, Thakur B. Bilateral Variability of Quadriceps Angle and Impact of Height on it in Female Population of Uttarakhand. Journal of Medical Academics 2024; 7 (2):56-59.
Background: The quadriceps angle (Q angle), an indicator of knee dysfunction, is formed by the line connecting the anterior superior iliac spine to the center of the patella and the line connecting the center of the patella to the tibial tuberosity. It is affected by the flexion and tonicity of the quadriceps femoris muscles. In females, the angle falls between 15 and 20°. The left and right legs are not always equal. Females tend to have a larger angle than men due to a broader pelvis. An increase in the angle is linked with instability of the patella and extensor dysfunction of the knee.
Materials and methods: The study was conducted in the anatomy department of a tertiary care center over 5 years, involving 370 females residing in the hilly and plain regions of Uttarakhand. The females were in the age-group of 18–65 years. Samples were collected in the supine position with the help of a universal goniometer.
Results: The Q angle was found to be higher in females from the plains compared to those from the hills. The mean value of the right Q angle was calculated as 12.02° in the hills and 13.27° in the plains. The mean value of the left Q angle was calculated as 11.49° in the hills and 12.62° in the plains.
Conclusion: In the plains, height has a nonsignificant correlation with the Q angle and may not be a strong predictor in this population. The left and right Q angles are highly correlated with each other. Height shows a weaker correlation with angle measurements in the hills.
Caylor D, Fites R, Worrell TW. The relationship between quadriceps angle and anterior knee pain syndrome. J Orthop Sports Phys Ther 1993;17(1):11–16. DOI: 10.2519/jospt.1993.17.1.11
Guerra JP, Arnold MJ, Gajdosik RL. Q angle: effects of isometric quadriceps contraction and body position. J Orthop Sports Phys Ther 1994;19(4):200–204. DOI: 10.2519/jospt.1994.19.4.200
Hvid I, Andersen LI. The quadriceps angle and its relation to femoral torsion. Acta Orthop Scand 1982;53(4):577–579. DOI: 10.3109/17453678208992261
Ferber R, Davis IM, Williams DS 3rd. Gender differences in lower extremity mechanics during running. Clin Biomech (Bristol) 2003;18(4):350–357. DOI: 10.1016/s0268-0033(03)00025-1
Woodland LH, Francis RS. Parameters and comparisons of the quadriceps angle of college-aged men and women in the supine and standing positions. Am J Sports Med 1992;20(2):208–211. DOI: 10.1177/036354659202000220
Malinzak RA, Colby SM, Kirkendall DT, et al. Comparison of knee joint motion patterns between men and women in selected athletic tasks. Clin Biomech (Bristol) 2001;16(5):438–445. DOI: 10.1016/s0268-0033(01)00019-5
Rauh MJ, Koepsell TD, Rivara FP, et al. Quadriceps angle and risk of injury among high school cross-country runners. J Orthop Sports Phys Ther 2007;37(12):725–733. DOI: 10.2519/jospt.2007.2453
Novacheck TF. The biomechanics of running. Gait Posture 1998;7(1):77–95. DOI: 10.1016/s0966-6362(97)00038-6
Protokinetics.com/understanding-phases-of-the-gait-cycle, Nov 28, 2018.
Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. Int J Sports Phys Ther 2016;11:820–830. PMID: 27904787.
Chhabra P, Setiya M, Godwin R. “Quadriceps angle”: an important indicator of biomechanical function of lower extremity and its relation with anterior knee pain. 2016;4:173–176.
Tsakoniti AE, Mandalidis DG, Athanasopoulos SI, et al. Effect of Q-angle on patellar positioning and thickness of knee articular cartilages. Surg Radiol Anat 2011;33:97–104. DOI: 10.1007/s00276-010-0715-4
Tiberio D. The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model. J Orthop Sports Phys Ther 1987;9:160–165. DOI: 10.2519/jospt.1987.9.4.160
Piva SR, Fitzgerald GK, Irrgang JJ, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil 2009;90:285–295. DOI: 10.1016/j.apmr.2008.08.214
Hahn T, Foldspang A. The Q angle and sport. Scand J Med Sci Sports 1997;7(1):43–48. DOI: 10.1111/j.1600-0838.1997.tb00116.x
Bayraktar B, Yucesir I, Ozturk A, Change of quadriceps angle values with age and activity. Saudi Med J 2004;25(6):756–760.
Livingston LA, Spaulding SJ. Measurement of the quadriceps angle using standardized foot positions. J Athl Train 2002;37:252–255. PMID: 12937581.
Livingston LA, Mandigo JL. Bilateral within-subject Q-angle asymmetry in young adult females and males. Biomed Sci Instrum 1997;33:112–117. PMID: 9731345.
Choudhary R, Malik M, Aslam A, et al. Effect of various parameters on quadriceps angle in adult Indian population. J Clin Orthop Trauma 2019;10(1):149–154. DOI: 10.1016/j.jcot.2017.11.011
Herrington L, Nester C. Q-angle undervalued? The relationship between Q-angle and medio-lateral position of the patella. Clin Biomech (Bristol) 2004;19(10):1070–1073. DOI: 10.1016/j.clinbiomech.2004.07.010
Khasawneh RR, Allouh MZ, Abu-El-Rub E. Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PLoS One 2019;14(6):e0218387. DOI: 10.1371/journal.pone.0218387
Shantanu K, Singh S, Kumar D, et al. Anatomical variation in quadriceps angle with regard to different anthropometric parameters in a tertiary care centre in northern India: a descriptive study. Cureus 2023;15(1):e34224. DOI: 10.7759/cureus.34224
Veeramani R, Shankar N, Narayanan S, et al. Gender differences in the mediolateral placement of patella and tibial tuberosity: a geometric analysis. Anatomy 2010;4:45–50. DOI: 10.2399/ana.09.039
Tella BA, Ulugo U, Odebiyi DO, et al. Gender variation of bilateral Q-angle in young adult Nigerians. Nig Q J Hosp Med 2010;20(3):114–116. PMID: 21033317.