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Not yet recruitingNCT07425340Updated Feb 20, 2026

Ultrasound Examination of the VMO in Patellofemoral Pain Syndrome

An observational study in Vastus Medialis, Ultrasonographic and Patello Femoral Pain Syndrome, sponsored by Hasan Kalyoncu University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-20.

Sponsored by Hasan Kalyoncu University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
40
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The aim of this study is to examine in detail the ultrasonographic characteristics of the vastus medialis obliquus and vastus medialis longus muscles in individuals with patellofemoral pain syndrome and to compare these findings with those of healthy individuals. It is anticipated that the results obtained will contribute to a better understanding of the muscle-based mechanisms of PFAS and provide a scientific basis for the development of muscle-specific assessment and intervention strategies in physical therapy and rehabilitation practices.

Read the detailed description

Patellofemoral pain syndrome (PFAS) is a musculoskeletal problem characterized by pain in the front of the knee joint, commonly seen in young and physically active individuals. The etiology of PFAS is multifactorial and is associated with abnormal loading of the patella within the femoral trochlear groove, alterations in joint biomechanics, and functional deficiencies of the surrounding soft tissues. These mechanical irregularities in the patellofemoral joint can lead to pain, loss of function, and activity limitations over time. The quadriceps femoris muscle group plays a fundamental role in providing dynamic stability to the patella. The vastus medialis obliquus (VMO) and vastus medialis longus (VML) muscles within this muscle group are critical for controlling the patella medially and maintaining its proper alignment within the femoral groove. It is known that the oblique fiber structure of the VMO muscle provides medial stabilizing force to the patella, while the VML muscle contributes to force production during knee extension and overall patellar guidance with its longer fibers. In individuals with PFAS, delayed activation patterns, decreased muscle strength, and morphological changes in the vastus medialis muscle have been reported. However, it is observed in the literature that the VMO and VML muscles are treated as a single structure in most studies, and the separate morphological characteristics of these two muscles and their relationship with patellofemoral pain have not been sufficiently investigated. However, the different anatomical, biomechanical, and functional characteristics of these muscles necessitate that their roles in PFAS pathophysiology be evaluated separately. Ultrasonography is a non-invasive, reliable, and reproducible imaging method for evaluating the morphological characteristics of muscle tissue and is increasingly used in clinical research. Ultrasonographic evaluation allows for the objective examination of muscle thickness, cross-sectional area, and architectural features, thereby providing important information about structural changes in muscle function. The aim of this study is to examine in detail the ultrasonographic characteristics of the vastus medialis obliquus and vastus medialis longus muscles in individuals with patellofemoral pain syndrome and to compare these findings with healthy individuals. It is anticipated that the results will contribute to the understanding of the muscle-based mechanisms of PFAS and provide a scientific basis for the development of muscle-specific assessment and intervention strategies in physical therapy and rehabilitation practices.

02

Conditions studied

  • Vastus Medialis
  • Ultrasonographic
  • Patello Femoral Pain Syndrome

Keywords

  • Patellofemoral Pain
  • Vastus Medialis Obliqus
  • Ultrasonographic measurement
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

The study will include individuals aged 18-65 who have been diagnosed with patellofemoral pain syndrome, as well as healthy volunteers with similar characteristics in terms of age and gender. The study group will consist of individuals who have applied to a physical therapy and rehabilitation clinic or who have been referred to relevant units. The control group will be selected from healthy volunteers who do not have any knee pain or lower extremity musculoskeletal problems.

Inclusion criteria

  • Between the ages of 18 and 65
  • Have had localized pain in the front of the knee for at least the past 3 months
  • Experience pain during activities that require stair climbing, squatting, prolonged sitting, or knee flexion
  • Have been diagnosed with patellofemoral pain syndrome based on clinical evaluation
  • Volunteer to participate in the study and sign the informed consent form

Exclusion criteria

Exclusion Criteria:

  • History of previous surgery on the knee joint
  • History of significant trauma to the knee region within the last 6 months
  • Diagnosis of meniscus, ligament injuries, knee osteoarthritis, or inflammatory rheumatic disease
  • Neurological diseases or systemic diseases affecting the musculoskeletal system
  • Presence of other lower extremity pathologies causing pain at a level that could affect measurements
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
40 participants (estimated)
Patient registry
No

Groups and cohorts

  • Study Group

    The study will include individuals aged 18-65 who have been diagnosed with patellofemoral pain syndrome, as well as healthy volunteers with similar characteristics in terms of age and gender.

  • Control group

    The study will include individuals aged 18-65 who have been diagnosed with patellofemoral pain syndrome, as well as healthy volunteers with similar characteristics in terms of age and gender.

05

What researchers measure

Primary outcomes

  1. Ultrasonographic Measurement

    A B-mode ultrasound device with a high-frequency (7-12 MHz) linear probe will be used to evaluate muscle architecture. Ultrasound is a reliable, reproducible, and non-invasive imaging method for assessing the morphological characteristics of muscle tissue. Ultrasonographic evaluations will be performed by an experienced researcher in musculoskeletal ultrasonography, in a quiet and standard environment. A high-frequency (7-12 MHz) linear probe will be used during measurements. Participants will be placed on the evaluation table in a supine position, with the knee joint fully extended and relaxed. Before measurements, anatomical reference points will be determined using a tape measure, and temporary markings will be made on the skin. Vastus Medialis Obliquus (VMO): VMO muscle thickness measurement will be performed in the region where the oblique orientation of the muscle fibers is prominent, using the upper-medial edge of the patella as a reference. The measurement point will be determ

    Time frame: through of the study, average 4 months

06

Study locations

1 site
  • Hasan Kalyoncu University
    Gaziantep, Şahinbey (505) 090-5846, Turkey (Türkiye)
07

References and documents

Publications

  • Engelina S, Antonios T, Robertson CJ, Killingback A, Adds PJ. Ultrasound investigation of vastus medialis oblique muscle architecture: an in vivo study. Clin Anat. 2014 Oct;27(7):1076-84. doi: 10.1002/ca.22413. Epub 2014 May 5. PubMed 24797580 ↗
  • Castanov V, Hassan SA, Shakeri S, Vienneau M, Zabjek K, Richardson D, McKee NH, Agur AMR. Muscle architecture of vastus medialis obliquus and longus and its functional implications: A three-dimensional investigation. Clin Anat. 2019 May;32(4):515-523. doi: 10.1002/ca.23344. Epub 2019 Feb 19. PubMed 30701597 ↗
  • Sawy MME, Mikkawy DMEE, El-Sayed SM, Desouky AM. Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain. Anat Cell Biol. 2021 Mar 31;54(1):1-9. doi: 10.5115/acb.20.258. PubMed 33262319 ↗
  • Davut S, Dogramaci Y. Evaluation of the relationship between the anatomical characteristics of the vastus medialis obliquus muscle and the patella chondral lesion occurrence. Jt Dis Relat Surg. 2024 Apr 26;35(2):330-339. doi: 10.52312/jdrs.2024.771. Epub 2024 Apr 26. PubMed 38727112 ↗
  • Dong C, Li M, Hao K, Zhao C, Piao K, Lin W, Fan C, Niu Y, Fei W. Dose atrophy of vastus medialis obliquus and vastus lateralis exist in patients with patellofemoral pain syndrome. J Orthop Surg Res. 2021 Feb 10;16(1):128. doi: 10.1186/s13018-021-02251-6. PubMed 33568152 ↗
  • Smith TO, Nichols R, Harle D, Donell ST. Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review. Clin Anat. 2009 Mar;22(2):183-99. doi: 10.1002/ca.20737. PubMed 19090000 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07425340
Lead sponsor
Hasan Kalyoncu University
Responsible party
Tuğba GÖNEN (Asisst. Prof. Dr., Hasan Kalyoncu University) — Principal investigator
First posted
Feb 20, 2026
Start date
Feb 25, 2026 (estimated)
Primary completion
Apr 25, 2026 (estimated)
Completion
Jun 25, 2026 (estimated)
Last update
Feb 20, 2026

Study contacts

Tuğba GÖNEN, Asisst. Prof. Dr.
Contact
tugba.badat@hku.edu.tr
505 090 58 46
Tuğba GÖNEN, Asisst. Prof. Dr.
principal investigator · Hasan Kalyoncu University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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