Gait Pathology in Subjects with Patellofemoral Instability: A Systematic Review

Int J Environ Res Public Health. 2022 Aug 23;19(17):10491. doi: 10.3390/ijerph191710491.


Identifying potential gait deviations in patellofemoral instability (PI) can help with the development of effective rehabilitation strategies. The purpose of this systematic review was to examine whether there are specific gait alterations in subjects with PI. The present review followed the PRISMA guidelines and was initially registered at PROSPERO (CRD42021236765). The literature search was carried out in the databases of PubMed, the Cochrane library, Web of Science,, and Medline. The search strategy resulted in the identification of seven relevant publications. Subjects with PI show decreased walking speed, stride length, and cadence. Some studies reported changes not only in knee kinematics and kinetics but also in hip and ankle kinematics and kinetics. There is evidence that most subjects with PI walk with a quadriceps avoidance gait and show increased genu valgum posture, but there is still great variability in the coping responses within individuals with PI. The discrepancy among the study results might underpin the fact that PI is a multifactorial problem, and subjects cope with the different underlying morphological as well as functional deficits using a variety of gait strategies, which makes the interpretation and understanding of the gait of subjects with PI a clinically challenging task.

Keywords: 3D gait analysis; gait alterations; patellofemoral instability.

Publication types

  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ankle Joint
  • Biomechanical Phenomena / physiology
  • Gait* / physiology
  • Humans
  • Knee Joint
  • Walking / physiology
  • Walking Speed* / physiology

Grants and funding

The authors acknowledge the financial support of the University of Graz. A.H. is currently funded by the Austrian Academy of Sciences (25940). A.K. is currently funded by the Austrian Science Fund (T1017).