The word 'mal' means 'bad' or 'poor'. 'Malalignment' implies that the relationship or geometry of one bone in relation to its neighbouring bone is outside of what one might consider normal.
Page updated March 2024 by Dr Sheila Strover (Clinical Editor)
What is patellar malalignment?
Patellar malalignment refers to a kneecap that is tilted or out of alignment with the underlying trochlear groove of the femur bone.
This may be due to soft tissue issues or bony problems.
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Quote from peer-reviewed paper:
"....Patellar malalignment (PM) associated with knee pain is common in all age groups, and the most common predisposing factor is imbalanced peripatellar soft-tissue tension...."
Citation: Wu CC. Patellar malalignment: A common disorder associated with knee pain. Biomed J. 2023 Oct;46(5):100658. doi: 10.1016/j.bj.2023.100658. Epub 2023 Sep 5. PMID: 37678711; PMCID: PMC10550501.
What is tibiofemoral malalignment?
Tibiofemoral malalignment refers to an abnormal angular relationship of the long bones of the lower limb to one another.
Usually this is a varus malalignment or a valgus malalignment.
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Quote from peer-reviewed paper:
"....Varus alignment shifts the load-bearing axis medial to knee center, creating a moment arm that increases forces across the medial compartment and reduces lateral load; the lateral shift of the load-bearing axis due to valgus alignment increases forces across the lateral compartment and reduces medial load....."
Citation: Sharma L, Song J, Dunlop D, Felson D, Lewis CE, Segal N, Torner J, Cooke TD, Hietpas J, Lynch J, Nevitt M. Varus and valgus alignment and incident and progressive knee osteoarthritis. Ann Rheum Dis. 2010 Nov;69(11):1940-5. doi: 10.1136/ard.2010.129742. Epub 2010 May 28. PMID: 20511608; PMCID: PMC2994600.
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