Functional hallux limitus (FHL) as a potential predisposing factor for anterior knee pain syndrome (AKPS). Results after endoscopic tenolysis of the flexor hallucis longus tendon: A prospective cohort study

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

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Does knee pain in the community behave like a regional pain syndrome? Prospective cohort study of incidence and persistence

Annals of the Rheumatic Diseases ◽

10.1136/ard.2006.061481 ◽

2007 ◽

Vol 66 (9) ◽

pp. 1190-1194 ◽

Cited By ~ 24

Author(s):

K T Palmer ◽

I Reading ◽

M Calnan ◽

C Linaker ◽

D Coggon

Keyword(s):

Cohort Study ◽

Knee Pain ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Pain Syndrome

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FRI0693 Synovial changes detected by ultrasonography and their association with osteoarthritis-related knee pain: a 1-year prospective cohort study

10.1136/annrheumdis-2017-eular.5764 ◽

2017 ◽

Author(s):

A Sarmanova ◽

M Hall ◽

GS Fernandes ◽

AM Valdes ◽

DA Walsh ◽

...

Keyword(s):

Cohort Study ◽

Knee Pain ◽

Prospective Cohort Study ◽

Prospective Cohort

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Anterior Knee-Pain Syndrome

10.1542/9781581104066-anterior ◽

2007 ◽

pp. 192-220

Author(s):

Gideon Mann ◽

Naama Constantini ◽

Iftach Hetsroni ◽

Omer Meidan ◽

Eran Dolev ◽

...

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Pain Syndrome ◽

Anterior Knee

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Arthroscopic Lateral Retinacular Ligament Release in Patellofemoral Pain Syndrome

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00187 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0018

Author(s):

Teoman Başaran ◽

Ahmet Ozgur Atay ◽

Mahmut Nedim Doral ◽

Pınar Özge Başaran

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Bleeding Time ◽

Pain Syndrome ◽

Patellofemoral Pain Syndrome ◽

Patellofemoral Pain ◽

Lateral Release ◽

Lateral Retinacular Release ◽

Anterior Knee ◽

Surgery Duration

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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