scholarly journals Effect of ultrasound-guided percutaneous neuromodulation applied to the femoral nerve on pain and range of motion in patients with anterior knee pain: A case study

2020 ◽  
Vol 03 (01) ◽  
pp. 030-034
Author(s):  
Paula García-Bermejo ◽  
Carlos Romero-Morales ◽  
Blanca de-la-Cruz-Torres
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Effect Size ◽  
Anterior Knee Pain ◽  
Femoral Nerve ◽  
Medium Effect ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Single Intervention ◽  
Anterior Knee

Abstract Introduction Anterior knee pain (AKP) is one of the most frequent reasons for physical therapy consultations, remaining a difficult treatment challenge for professionals. The aim of this study was to evaluate the effects of an intervention using ultrasound-guided percutaneous neuromodulation (US-guided PNM) applied to the femoral nerve on pain and knee flexion range of motion (ROM), in patients with unilateral chronic anterior knee pain. Methods Eight patients received a single intervention of NMP-e on the femoral nerve of the symptomatic knee. The level of pain and ROM were measured before, immediately after and 24 hours after the intervention. Results A decrease in pain and an increase of ROM were observed after the intervention and at 24 hours. For pain values, a medium effect size was observed (ES = 0.63 ± 0.43) after the intervention, and a large effect size (ES = 1.73 ± 0.44) was found at 24h. Concerning ROM, the effect size was large at both moments (ES = − 1.30 ± 1.14; −1.76 ± 0.80, respectively). Conclusion A single intervention of US-guided PNM on the femoral nerve produces a decrease of pain and increases the ROM, which is greater 24h after the stimulation. Level of Evidence Level II-3.

scholarly journals Ultrasound-Guided Percutaneous Neuromodulation in Patients with Unilateral Anterior Knee Pain: A Randomized Clinical Trial

2020 ◽  
Vol 10 (13) ◽  
pp. 4647
Author(s):  
Paula García-Bermejo ◽  
Blanca De-la-Cruz-Torres ◽  
Carlos Romero-Morales
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Knee Flexion ◽  
Femoral Nerve ◽  
Single Shot ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Anterior Knee

The objective of this study was to evaluate the short-term and crossover effects of a percutaneous neuromodulation (PNM) intervention on the femoral nerve, regarding the pain, knee flexion motion (range of motion (ROM)), and functionality, in patients with unilateral anterior knee pain (AKP). Our study used a randomized clinical trial design. Thirty patients were divided into two groups: one asymptomatic knee group in which patients received stimulation in the femoral nerve corresponding to the nonsymptomatic knee; and one symptomatic knee group, in which patients received stimulation in the femoral nerve corresponding to the painful knee. Pain, knee flexion ROM, Victorian Institute of Sport Assessment-Patella (VISA-P) and Kujala questionnaires were evaluated. Twenty-eight patients completed the study. Compared to their baseline values, both groups showed an increase immediately at 24 h, and at 1 week for the knee flexion ROM variable. In addition, the symptomatic knee group showed an increase for the Kujala score and a decrease for the numeric rating scale (NRS) variable from baseline to 1 week. VISA-P score did not show statistically significant differences for the time-group interaction. After the intervention, there were no differences between the groups in any measured time. Conclusion: a single-shot ultrasound-guided PNM intervention per week in the femoral nerve may be an effective treatment for improving the pain, knee flexion ROM, and knee functionality. In addition, this technique produces crossover benefits in the nonintervention limb.

scholarly journals Application of ultrasound-guided percutaneus neuromodulation (PNM) in women with anterior knee pain

2019 ◽  
Vol 02 (02) ◽  
pp. 072-072
Author(s):  
García-Bermejo P. ◽  
Albornoz-Cabello M. ◽  
De la Cruz-Torres B.
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Femoral Nerve ◽  
Ultrasound Guided ◽  
Post Intervention ◽  
Phase Duration ◽  
Affected Side ◽  
Significant Difference ◽  
Anterior Knee ◽  
Experimental Group

Abstract Background Anterior knee pain (AKP) is one of the most common pathologies of the lower limb, with an incidence that is 2.2% greater in women than in men. Electric currents have been used as an effective treatment for pain in many pathologies, however, the percutaneous application of the same has represented a particularly great advancement. In the field of physical therapy, ultrasound-guided percutaneous neuromodulation (US-guided PNM), is a technique that is being developed with promising results, however there is still a scarcity of studies concerning this technique. Aim To evaluate the improvement in chronic anterior knee pain symptoms after the application of US-guided PNM on the femoral nerve of the affected side or the healthy side, in a population of women. Material and Methods The sample comprised 15 women with chronic unilateral AKP, who were randomly divided into two groups: experimental group 1 (n = 8), who received US-guided PNM upon the femoral nerve, on the leg of the affected side, and an experimental group 2 (n = 7), who received US-guided PNM on the femoral nerve of the non-affected side. The intervention was performed using a needle measuring 0.3 × 40mm on the motor fibers of the femoral nerve under ultrasound guidance and using a monopolar electrode, with a frequency of 10 Hz and a phase duration of 250 microseconds, during 1.5 minutes. We registered active ROM in both knees, pain according to the Visual Analog Scale (VAS) and functionality using the VISA-P questionnaire and the Kujala scale. All variables were evaluated pre-intervention, post-intervention and after 24 hours. Results No statistically significant differences were found in both groups between the pre and post intervention measurements. However, statistically significant changes were found in both groups between the pre and post intervention at 24 hours, regarding increased ROM and functionality and a decrease in pain (p < 0.05). Nonetheless, the between-group comparison did not obtain a significant difference in any of the variables studied (p > 0.05). The measurement of the effect size obtained a large clinical effect between both groups and between the pre-intervention measurement and the assessment at 24 hours. Conclusion Treatment of chronic AKP in women, using US-guided PNM, leads to an improvement of symptoms and functionality, 24 hours after application of the same, regardless of whether it is applied on the femoral nerve of the affected leg or on that of the healthy leg.

Runners With Anterior Knee Pain Use a Greater Percentage of Their Available Pronation Range of Motion

2013 ◽  
Vol 29 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Pedro Rodrigues ◽  
Trampas TenBroek ◽  
Joseph Hamill
Keyword(s):  
At Risk ◽  
Risk Factor ◽  
Range Of Motion ◽  
Motion Capture ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
System Dynamic ◽  
Motion Capture System ◽  
Alternative Method ◽  
Anterior Knee

“Excessive” pronation is often implicated as a risk factor for anterior knee pain (AKP). The amount deemed excessive is typically calculated using the means and standard deviations reported in the literature. However, when using this method, few studies find an association between pronation and AKP. An alternative method of defining excessive pronation is to use the joints’ available range of motion (ROM). The purposes of this study were to (1) evaluate pronation in the context of the joints’ ROM and (2) compare this method to traditional pronation variables in healthy and injured runners. Thirty-six runners (19 healthy, 17 AKP) had their passive pronation ROM measured using a custom-built device and a motion capture system. Dynamic pronation angles during running were captured and compared with the available ROM. In addition, traditional pronation variables were evaluated. No significant differences in traditional pronation variables were noted between healthy and injured runners. In contrast, injured runners used significantly more of their available ROM, maintaining a 4.21° eversion buffer, whereas healthy runners maintained a 7.25° buffer (P= .03, ES = 0.77). Defining excessive pronation in the context of the joints’ available ROM may be a better method of defining excessive pronation and distinguishing those at risk for injury.

scholarly journals Effect of Patellar Resurfacing on Clinical Outcomes, Range of Knee Motion and Anterior Knee Pain in Patients with Total Knee Arthroplasty

2019 ◽  
Vol 20 (4) ◽  
pp. 309-312
Author(s):  
Ozgur Korkmaz ◽  
Yıldıray Genc ◽  
Osman Cimen ◽  
Ismail Oltulu ◽  
Deniz Gülabi ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Knee Society Score ◽  
Clinical Results ◽  
Patellar Resurfacing ◽  
Knee Motion ◽  
Significant Difference ◽  
Anterior Knee

Abstract Objectives: In this study, we retrospectively compare the clinical results, range of knee motion and anterior knee pain in patients on whom we performed knee arthroplasty with and without patellar resurfacing. Thirty-eight patients were evaluated in the study. Knee Society scores, knee range of motion and anterior knee pain before and 12 months after surgery were detected. Patients were divided into two groups: resurfaced patellas and nonresurfaced patellas. There were 18 patients in the resurfaced group and 20 patients in the nonresurfaced group. Mean Knee Society score was 40.72±13.09 in the resur-faced group and 38.55±5.88 in the nonresurfaced group before surgery. Mean Knee Society score was 80.38±7.78 in the resur-faced group and 80.10±3.22 in the nonresurfaced group in the last control. Mean knee range of motion was 92.83±12.12 degrees in the resurfaced group and 91.05±10.10 degrees in the nonresurfaced group before surgery. Mean range of motion was 106.22±9.13 degrees in the resurfaced group and 97.25±8.50 degrees in the nonresurfaced group after surgery. There were twelve patients with anterior pain before surgery in the resur-faced group and 13 patients with anterior knee pain before surgery in the nonresurfaced group. After surgery, there was one patient with anterior pain in the resurfaced group and 9 patients with anterior knee pain in the nonresurfaced group. Anterior knee pain ratio was smaller in the resurfaced group than in the nonresurfaced group, and there was a significant difference in range of knee motion as a result of our study. We offered to resurface the patella.

120 Genicular Nerve Radio-Frequency Ablation in The Treatment of Anterior Knee Pain in Patients with Osteoarthritis of The Knee Joint: Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Farrugia ◽  
C Tinning
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Comparative Studies ◽  
Primary Outcome ◽  
Final Analysis ◽  
Primary Outcome Measure ◽  
Sensory Innervation ◽  
Osteoarthritis Of The Knee ◽  
Pain Scores ◽  
Anterior Knee

Abstract Anterior knee pain is one of the main symptoms in osteoarthritis, resulting from the rich sensory innervation of its capsule. Pain control can be difficult to achieve, with non-responders to conservative and medical therapy often requiring a total knee replacement. Radiofrequency ablation (RFA) is a novel technique that could be beneficial in managing anterior knee pain by targeting the genicular nerves around the knee; however, its routine use is not included in current guidelines. A literature search identified fifty-two results, which underwent screening using a study protocol and the final literature sources, of varying levels of evidence, underwent critical appraisal and analysis. The primary outcome included the significant improvement of pain scores from baseline, against their respective control treatments. The ten studies included in the final analysis consisted of seven comparative studies and three non-comparative studies. Literature showed significant improvement in their mean pain scores, all meeting the primary outcome measure. Most studies also showed significant improvement from the control treatments used. Current literature shows evidence that genicular nerve RFA is an effective and safe treatment modality in the management of anterior knee pain secondary to osteoarthritis. However, the literature available is limited and further comparative studies are required.

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