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Clinical and Radiological Assessment of the Anterior Knee Pain Patient

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Anterior Knee Pain and Patellar Instability

Abstract

Anterior knee pain (AKP), which is pain behind or around the patella, is one of the most common reasons for consultation with an orthopedic surgeon specializing in the knee among teenagers and young adults.

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References

  1. Crossley KM, Callaghan MJ, van Linschoten R. Patellofemoral pain. Br J Sports Med. 2016;50(4):247–50.

    Article  PubMed  Google Scholar 

  2. Post WR. History and physical examination. In: Fulkerson JP (ed) Disorders of the patellofemoral joint. 4th edition. Lippincott Williams & Wilkins Philadelphia, 2004; pp 43–75.

    Google Scholar 

  3. Crossley KM, Bennell KL, Cowan SM, et al. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil. 2004;85:815–22.

    Article  PubMed  Google Scholar 

  4. Bouhassira D, Attal N, Alchaar H, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1–2):29–36.

    Article  PubMed  Google Scholar 

  5. Robertson CJ, Hurley M, Jones F. People’s beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: a qualitative study. Musculoskelet Sci Pract. 2017;28:59–64.

    Article  PubMed  Google Scholar 

  6. Domenech J, Sanchis-Alfonso V, Lopez L, et al. Influence of kinesiophobia and catastrophizing on pain and disability in anterior knee pain patients. Knee Surg Sports Traumatol Arthrosc. 2013;21(7):1562–8.

    Article  PubMed  Google Scholar 

  7. Wride J, Bannigan K. Investigating the prevalence of anxiety and depression in people living with patellofemoral pain in the UK: the Dep-Pf study. Scand J Pain. 2019;24;19(2):375–382.

    Google Scholar 

  8. McManus S, Bebbington P, Jenkins R, Brugha T, editors. Mental health and well-being in England: Adult psychiatric morbidity survey 2014. Leeds: NHS Digital, 2016.

    Google Scholar 

  9. Sigmund KJ, Hoeger Bement MK, Earl-Boehm JE. Exploring the pain in patellofemoral pain: a systematic review and meta-analysis examining signs of central sensitization. J Athl Train. 2021;56(8):887–901.

    Article  PubMed  Google Scholar 

  10. Fulkerson JP. The etiology of patellofemoral pain in young, active patients: a prospective study. Clin Orthop. 1983;179:129–33.

    Article  Google Scholar 

  11. Ficat P, Ficat C, Bailleux A. [External hypertension syndrome of the patella. Its significance in the recognition of arthrosis] Rev Chir Orthop Reparatrice Appar. 1975;Mot 61:39–59.

    Google Scholar 

  12. Hejgaard N, Arnoldi CC. Osteotomy of the patella in the patellofemoral pain syndrome. The significance of increased intraosseous pressure during sustained knee flexion. Int Orthop. 1987;8:189–194.

    Google Scholar 

  13. Allen GM, Tauro PG, Ostlere SJ. Proximal patellar tendinosis and abnormalities of patellar tracking. Skeletal Radiol. 1999;28:220–3.

    Article  CAS  PubMed  Google Scholar 

  14. Rathleff MS, Roos EM, Olesen JL, et al. Lower mechanical pressure pain thresholds in female adolescents with patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2013;43(6):414–21.

    Article  PubMed  Google Scholar 

  15. Daniel D, Akeson W, O’Connor J. Knee Ligaments. Structure, Function, Injury and Repair. Raven Press, 1990.

    Google Scholar 

  16. Sanchis-Alfonso V, Coloma-Saiz J, Herrero-Herrero M, et al. Evaluation of anterior knee pain patient: clinical and radiological assessment including psychological factors. Ann Joint. 2018;3:26.

    Article  Google Scholar 

  17. Sanchis-Alfonso V, McConnell J, Monllau JC, et al. Diagnosis and treatment of anterior knee pain. JISAKOS, 2016. https://doi.org/10.1136/jisakos-2015-000033.

  18. Piva SR, Goodnite EA, Childs JD. Strength around the hip and flexibility of soft tissues in individuals with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2005;35(12):793–801.

    Article  PubMed  Google Scholar 

  19. Witvrouw E, Lysens R, Bellemans J, et al. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A 2-year prospective study. Am J Sports Med 2000;28(4):480–489.

    Google Scholar 

  20. Rathleff MS, Rathleff CR, Crossley KM, et al. Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis. Br J Sports Med. 2014;48:1088.

    Article  CAS  PubMed  Google Scholar 

  21. Giles LS, Webster KE, McClelland JA, et al. Does quadriceps atrophy exist in individuals with patellofemoral pain? A systematic literature review with meta-analysis. J Orthop Sports Phys Ther. 2013;43:766–76.

    Article  PubMed  Google Scholar 

  22. Sanchis-Alfonso V, Tey M, Monllau JC. A Novel Association between Femoroacetabular Impingement and Anterior Knee Pain. Pain Res Treat. 2015;2015: 937431.

    PubMed  PubMed Central  Google Scholar 

  23. Vallotton J, Echeverri S. Clinical examination of the patellofemoral patient. In: Zaffagnini S, Dejour D, Arendt EA, editors. Patellofemoral Pain, Instability, and Arthritis. Berlin Heidelberg: Springer; 2010. p. 41–9.

    Chapter  Google Scholar 

  24. Rabin A, Portnoy S, Kozol Z. The association of ankle dorsiflexion range of motion with hip and knee kinematics during the lateral step-down test. J Orthop Sports Phys Ther. 2016;46:1002–9.

    Article  PubMed  Google Scholar 

  25. Herrero-Herrero M, García-Massó X, Martínez-Corralo C, et al. Relationship between the practices of physical activity and quality of movement in adolescents: a screening tool using self-organizing maps. Phys Sportsmed. 2017;45(3):271–9.

    Article  PubMed  Google Scholar 

  26. Teitge RA, Faerber WW, Des Madryl P. Stress radiographs of the patellofemoral joint. J Bone Joint Surg. 1996;78-A:193–203.

    Google Scholar 

  27. Murphy SB, Simon SR, Kijewski PK, et al. Femoral anteversion. J Bone Joint Surg Am. 1987;69(8):1169–76.

    Article  CAS  PubMed  Google Scholar 

  28. Kaiser P, Attal R, Kammerer M, et al. Significant differences in femoral torsion values depending on the CT measurement technique. Arch Orthop Trauma Surg. 2016;136(9):1259–64.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Yoshioka Y, Cooke TD. Femoral anteversion: assessment based on function axes. J Orthop Res. 1987;5(1):86–91.

    Article  CAS  PubMed  Google Scholar 

  30. Yoshioka Y, Siu DW, Scudamore RA, et al. Tibial anatomy and functional axes. J Orthop Res. 1989;7(1):132–7.

    Article  CAS  PubMed  Google Scholar 

  31. Mucha A, Dordevic M, Testa EA, et al. Assessment of the loading history of patients after high tibial osteotomy using SPECT/CT–a new diagnostic tool and algorithm. J Orthop Surg Res. 2013;8:46.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hirschmann MT, Iranpour F, Davda K, et al. Combined single-photon emission computerized tomography and conventional computerized tomography (SPECT/CT): clinical value for the knee surgeons? Knee Surg Sports Traumatol Arthrosc. 2010;18:341–5.

    Article  PubMed  Google Scholar 

  33. Sim JA, Na YG, Lee BK, et al. Alignment changes after open-wedge high tibial osteotomy result in offloading in the patellofemoral joint: a SPECT/CT analysis. Knee Surg Sports Traumatol Arthrosc. 2020. https://doi.org/10.1007/s00167-020-06115-0.

    Article  PubMed  Google Scholar 

  34. Braun M, Cachovan M, Kaul F, et al. Accuracy comparison of various quantitative [99mTc]Tc-DPD SPECT/CT reconstruction techniques in patients with symptomatic hip and knee joint prostheses. EJNMMI Res. 2021.https://doi.org/10.1186/s13550-021-00794-7

  35. Dye SF, Boll DA. Radionuclide imaging of the patellofemoral joint in young adults with anterior knee pain. Orthop Clin North Am. 1986;17:249–62.

    Article  CAS  PubMed  Google Scholar 

  36. Näslund JE, Odenbring S, Näslund UB, et al. Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome. Br J Sports Med. 2005;39(3):162–5.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Draper CE, Fredericson M, Gold GE, et al. Patients with patellofemoral pain exhibit elevated bone metabolic activity at the patellofemoral joint. J Orthop Res. 2012;30(2):209–13.

    Article  CAS  PubMed  Google Scholar 

  38. Dye SF. The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. Clin Orthop Relat Res. 2005;436:100–10.

    Article  Google Scholar 

  39. Ro DH, Lee HY, Chang CB, et al. Value of SPECT-CT imaging for middle-aged patients with chronic anterior knee pain. BMC Musculoskelet Disord. 2015;16:169.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Lorberboym M, Ami DB, Zin D, et al. Incremental diagnostic value of 99mTc methylene diphosphonate bone SPECT in patients with patellofemoral pain disorders. Nucl Med Commun. 2003;24:403–10.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Vicente Sanchis-Alfonso .

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Sanchis-Alfonso, V., Ramírez-Fuentes, C., López-Company, L., Sopena-Novales, P. (2023). Clinical and Radiological Assessment of the Anterior Knee Pain Patient. In: Sanchis-Alfonso, V. (eds) Anterior Knee Pain and Patellar Instability. Springer, Cham. https://doi.org/10.1007/978-3-031-09767-6_5

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  • DOI: https://doi.org/10.1007/978-3-031-09767-6_5

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  • Print ISBN: 978-3-031-09766-9

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