PPatellar alignment is generally evaluated using X-ray, computed tomography, and magnetic resonance imaging (MRI). Thus, a quantitative evaluation of the patellar tilt and shift is necessary to evaluate knee condition, , ]. Patellar tilt and shift are proxies for the lateral patellar alignment, and both are potentially related to PFP, ,, ]. Excessive lateral alignment of the patella, a typical patellar malalignment, can lead to an increase in contact pressure in the patellofemoral joint, resulting in PFP and early degeneration of the patellofemoral joint. Patellar malalignment is a potential risk factor of patellofemoral pain (PFP), ,, ] and many studies have investigated the association between patellar malalignment and PFP, ,, ].
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