Knee kinetic pattern during gait and anterior knee pain before and after rehabilitation in patients with patellofemoral pain syndrome

Objectives: Arthroscopic lateral retinacular release in patellofemoral pain syndrome Comparing the amount of hemorrhage and times of release between electrocautery and a new techniques for arthroscopic lateral release with scissors Methods: 77 patients included in this prospective randomized controlled study. Inclusion Criteria: 1. Over the age of fourteen and have anterior knee pain syndrome 2. Tightness in lateral part of knee 3. Despite receiving conservative treatment for 6 months, patients who have anterior knee pain complaints Exclusion Criteria: 1. Diseases that prolong bleeding time 2. Drugs that prolong bleeding time 3. Abnormal APTT-INR levels 4. Patients underwent anterior cruciate reconstruction surgery 5. Patients underwent microfracture surgery 6. Patients underwent meniscus repair surgery 7. Patients underwent synovectomy -- Due to inflammatory diseases and synovial chondromatosis is excluded from the study. In this study 77 (25M 52W med age 50,14 ± 14,17 ) patients divided into three groups which was similar in age and sex. All patients underwent standard arthroscopic surgery for patellofemoral knee sydrome and meniscal debridement 1. Group 1 (Control) (n:10) LRL was preserved 2. Group 2 (Scissors) (n:33) LRL was released with Scissors 3. Group 3 (Electrocautery) (n:34) LRL was released with Electrocautery Results: There was no difference between the groups in terms of socio-demographic characteristics. All lateral ligaments releases were performed under tourniquet . The release is not considered to be complete unless the patella can be stood on its medial edge without difficulty . In all patients, surgery duration was recorded. To calculate the amount of bleeding the blood in the drainage tube was recorded for 24 hours after surgery. For 67 patients based on clinical examination at surgery and in the immediate postoperative period, all releases were felt to be adequate. For all groups total bleeding at 24 h postoperatively is the statistically same (p:0.850) . In first 8 hours the amount of bleeding is more in scissors group (p:0.002). Lateral release time is longer in electrocautery group (380 seconds) than in scissors group (24 seconds). In release with electrocautery sometimes we used additional techniques scissors and scalpel for enough release. There was no difference between groups in terms of complications such as deep vein thrombosis , hemarthrosis or severe complications. Conclusion: In this study the amount of bleeding was the same in the groups but surgery duration was longer in electrocautery group. Our new technique for intraarticular arthroscopy guided lateral retinacular release uses with scissors which is simple, effective, rapid, and have resulted a few surgical complications such as superficial skin infection which responds oral antibiotics. Electrocautery is difficult and needs experience.

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Diagnostic Accuracy of the Electromyography Parameters Associated With Anterior Knee Pain in the Diagnosis of Patellofemoral Pain Syndrome

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2014.03.028 ◽

2014 ◽

Vol 95 (8) ◽

pp. 1521-1526 ◽

Cited By ~ 18

Author(s):

Deisi Ferrari ◽

Heloyse Uliam Kuriki ◽

Cristiano Rocha Silva ◽

Neri Alves ◽

Fábio Mícolis de Azevedo

Keyword(s):

Diagnostic Accuracy ◽

Knee Pain ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Anterior Knee

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Reliability of clinical methods in evaluating patellofemoral pain syndrome with malalignment

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170902 ◽

2017 ◽

Vol 3 (3) ◽

pp. 334

Author(s):

Arjun R. H. H. ◽

Rama Kishan ◽

Dhillon M. S. ◽

Devender Chouhan

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Patellar Instability ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Step Test ◽

Clinical Test ◽

Clinical Tests ◽

Anterior Knee

Background: Diagnosis of patellofemroal pain syndrome has been challenging due to lack of clinical test with better sensitivity and specificity, axial imaging has been considered as the standard modality for evaluation. Patients with anterior knee pain because of patellofemoral pain syndrome can be sub-grouped as those with or without radiological positive parameter for patellar maltracking. The aim of the present study was to evaluate reliability of clinical tests in two subgroups of patients presenting with patellofemoral pain syndrome.Methods: 45 knees with anterior knee pain without any episode of patellar instability were evaluated clinically using four standard tests (patellar apprehension test (PAT), eccentric step test (EST), active instability test (AIT) and Waldron’s test. On the basis of CT scan finding (at least one positive radiological parameter of instability) 28 knees were categorized in Group A (potential patellar instability group) and 17 knees in Group B (PFPS).Results: All patients with 3 or more than three clinical test positive were cases with potential patellofemroal instability except two. Whereas other true patellofemroal pain patients all except 2 were have less than 3 positive clinical tests. Conclusions: Clinical test have more diagnostic accuracy in evaluating anterior knee pain due to potential patellofemroal instability in comparison to patellofemroal pain without radiological instability.

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Efficacy of Kinesio Taping and McConnell Taping Techniques in the Management of Anterior Knee Pain

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0369 ◽

2020 ◽

Vol 29 (1) ◽

pp. 79-86

Author(s):

Rumit S. Kakar ◽

Hilary B. Greenberger ◽

Patrick O. McKeon

Keyword(s):

Knee Pain ◽

Visual Analog Scale ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Drop Jump ◽

Analog Scale ◽

Kinesio Taping ◽

Anterior Knee

Context: Anterior knee pain also known as patellofemoral pain syndrome is a frequently encountered musculoskeletal disorder that worsens with activity. The multifactorial etiology of patellofemoral pain syndrome alters lower-extremity mechanics, increasing patellofemoral joint stresses during weight-bearing tasks. Kinesio and McConnell tapings are often incorporated into the treatment, but their efficacy is still unclear. Objective: To test the efficacy of Kinesio taping, McConnell taping, and sham taping in improving knee mechanics and reducing pain during activity. Design: Cross-sectional design. Setting: Clinical biomechanics laboratory. Participants: Ten participants (age: 20.3 [1.5] y, height: 169.9 [10.4] cm, and mass: 70.17 [13.1] kg) with anterior knee pain and no history of trauma. Intervention: Three trials each of squat, drop jump, and step-down tasks with 3 taping conditions in a counterbalanced order. Main Outcome Measures: Two-dimensional motion capture data of lower-extremities in frontal and sagittal planes were recorded and analyzed using 3 iPads and Spark Motion® application. Pooled effect sizes (Hedges’ g), 95% confidence intervals, and repeated-measures analysis of variance (P < .05) compared baseline and taping conditions during exercises for pain Visual Analog Scale and knee flexion in all exercises, hip abduction during step-down and drop jump, frontal plane projection during step-downs, and knee translation in sagittal plane during squats. Results: Significant reductions in Visual Analog Scale were recorded during squats between tapes (F2.505,12.867 = 3.407, P = .04, Hedges’ g = −0.70). Pairwise comparison showed a decrease in Visual Analog Scale for sham taping (mean difference = 1.14 cm, P = .01) and Kinesio taping (mean difference = 1.54 cm, P = .02) compared with baseline during squats. Conclusions: A variety of taping methods can potentially reduce perceived pain in individuals with patellofemoral pain syndrome, allowing clinicians to perform rehabilitation exercises. Sensory effects associated with short-term taping may be sufficient enough to modify knee pain acutely by afferent input blocking nocioceptive pain before the participants could adapt. Most interestingly, the sham taping technique demonstrated promise for enhancing functional outcomes, depending on the length of the tape and area covered.

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Does patellofemoral pain syndrome consider the most common differential diagnosis for anterior knee pain: an experts opinion

Physiotherapy ◽

10.1016/j.physio.2016.10.388 ◽

2016 ◽

Vol 102 ◽

pp. e64

Author(s):

M. Alkasem ◽

L. Herrington ◽

S. Porter

Keyword(s):

Differential Diagnosis ◽

Knee Pain ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Anterior Knee

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Analysis of pain, functional capacity, muscular strength and balance in young women with Patellofemoral Pain Syndrome

Fisioterapia em Movimento ◽

10.1590/1980-5918.030.003.ao01 ◽

2017 ◽

Vol 30 (3) ◽

pp. 433-441

Author(s):

Camile Ludovico Zamboti ◽

Rubens Alexandre da Silva Junior ◽

Cynthia Gobbi ◽

Leonardo Shigaki ◽

Christiane de Souza Guerino Macedo

Keyword(s):

Muscle Strength ◽

Knee Pain ◽

Functional Capacity ◽

Anterior Knee Pain ◽

Postural Balance ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Sedentary Women ◽

Anterior Knee

Abstract Introduction: Patellofemoral Pain Syndrome (PFPS) is associated with anterior knee pain, changes in functional capacity, balance and muscle strength disorders. Objective: To quantify pain, functional capacity, strength in quadriceps (Q), gluteus medium (GM), hip external rotator (ER) muscles and balance in sedentary women with PFPS. Methods: Twenty sedentary women, aged 18 to 25 years, were divided into two groups: PFPS (N=10) and control group (N=10). All the volunteers answered the items of the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale, the Anterior Knee Pain Scale (AKPS), and the Lower Extremity Functional Scale (LEFS). The participants performed the following tests: maximal voluntary isometric contraction measured by dynamometry; postural balance using the Star Excursion Balance Test (SEBT) and a force platform. Statistical analyses were performed using the Shapiro Wilk test, the Mann Whitney U test and Spearman’s correlation coefficient. Data were submitted to SPSS 20 software. Results: The PFPS group presented greater pain, balance impairment and higher average velocity of oscillation; however, no differences were observed in Q, GM and RE muscle strength and in balance analyzed by SEBT. Conclusion: Women with PFPS exhibited greater pain, worse functional capacity and body balance. Moderate correlation between both balance tests suggests the use of SEBT when the force platform is not available, which could facilitate and highlight the importance of clinical diagnosis with regard to postural balance.

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The Effect of Kinesio Taping on Anterior Knee Pain Consistent With Patellofemoral Pain Syndrome: A Critically Appraised Topic

Journal of Sport Rehabilitation ◽

10.1123/jsr.2014-0278 ◽

2016 ◽

Vol 25 (3) ◽

pp. 288-293

Author(s):

Samantha A. Campbell ◽

Alison R. Valier

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Musculoskeletal Injuries ◽

Clinical Scenario ◽

Clinical Question ◽

Kinesio Taping ◽

Anterior Knee

Clinical Scenario:Patellofemoral pain syndrome (PFPS) occurs in 25% of adolescents and adults and is the leading cause of knee pain in runners. Pain is commonly felt when ascending or descending stairs, deep squatting, kneeling, or running. There is no consensus on the etiology of this condition, but insufficient hip strength, malalignment of the lower extremity, hyperpronation of the foot, and patellar incongruence have been suggested. Common treatments of PFPS include strengthening of quadriceps and hip muscles, McConnell taping, electrical stimulation, and foot orthotics, but effectiveness of these treatments is inconclusive. Kinesio Taping is an alternative taping technique for musculoskeletal injuries including PFPS. Although research suggests that Kinesio Taping decreases pain and improves range of motion for some musculoskeletal injuries, its effectiveness in decreasing pain in patients with PFPS in unknown. Furthermore, Kinesio Taping has not been compared with other taping techniques including McConnell taping.Focused Clinical Question:For patients with anterior knee pain consistent with PFPS, does treatment with Kinesio Taping decrease pain more than McConnell taping or no tape at all?

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Influence of changes in hip bone morphology and anterior knee pain

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2016.14.434 ◽

2020 ◽

pp. 1-4

Author(s):

Hugo Machado Sanchez ◽

Layla Rosa de Castro ◽

Beatriz Santana Borges ◽

Eliane Gouveia de Morais Sanchez ◽

Jair Pereira de Melo Junior

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Pelvic Tilt ◽

Morphological Changes ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Bone Morphology ◽

Lateral Tilt ◽

Anterior Knee

Introduction: The patellofemoral pain syndrome (PFPS) is one of the most common disorders of the knee, and there is still unclear etiology. Objective: The aim of this study was to correlate patellofemoral pain syndrome with the bone morphology of hip. Method: For this, this study evaluated 31 studied volunteers with aged between 18 and 30 years, which analyzed the distance of anterior superior iliac spines (ASIS), asymmetry of the pelvis, lower limb length (LL), distance from the ASIS bilaterally of the patella, lateral tilt and iliac inclination, this by computerized biophotogrammetry. Results: After collecting the data and consequent tabulation, it was found that were no changes in the data collected except in the lateral tilt, so the volunteers who had anterior knee pain also had lateral pelvic tilt. Conclusion: That said, we can infer that there is little relationship between the morphological changes of the hip with the PFPS, whereas found only one was in lateral pelvic tilt voluntary group who complained of pain above the knee.

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