Prevalence and Role of Psychiatric Conditions in Patients Diagnosed with Anterior Knee Pain (192)

Objectives: Anterior knee pain is a common musculoskeletal complaint with a multifactorial etiology. Psychiatric conditions may play a significant role in both the evolution of anterior knee pain and recovery from it. This retrospective, matched case-control study evaluates the prevalence of psychologic conditions in patients with anterior knee pain to assess their role as a potential contributor. Methods: 126 patients with anterior knee pain were retrospectively identified using ICD-10 codes and were individually matched to controls based on gender, age, and BMI. Patient demographics, surgical history, medications, and prior or current diagnoses related to musculoskeletal or psychiatric health were recorded. Demographic data between the anterior knee pain group and controls were evaluated using independent t-tests. Differences between the matched pairs related to psychiatric conditions and medication usage were evaluated using a McNemar Test. A subgroup analysis was also performed and defined by gender, age greater than or less than 35, and BMI greater than or less than 25. Results: Evaluation of demographic data between the anterior knee pain group and controls showed no difference with regards to age, gender, and BMI (p>0.05). Analysis of the 126 matched pairs demonstrated similar rates of psychiatric conditions and medication usage between the anterior knee pain group (23 patients, 18.3%) and the control group (18 patients, 14.3%). Statistically, there was no difference between the two groups (p = 0.472). A subgroup analysis also demonstrated no difference between the anterior knee pain group and controls when stratified by gender (Male [p = 0.80]; Female [p = 0.12]), age (< 35 [p = 1.00]; > 35 [p = 0.50]), and BMI (< 25 [p = 0.10]; > 25 [p = 0.82]). Conclusions: There was no difference in the prevalence of psychiatric conditions between patients with anterior knee pain and their controls. This suggests a low likelihood that the psychologic condition of patients with anterior knee pain differ from that of the general population and implies that psychologic conditions alone are unlikely to play an isolated role in the etiology of anterior knee pain.

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Patelloplasty with and without circumpatellar denervation in reducing anterior knee pain in primary total knee arthroplasty: a comparative prospective study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200046 ◽

2020 ◽

Vol 6 (2) ◽

pp. 270

Author(s):

Sandeep Kumar Kanugula ◽

Mallesh Rathod ◽

Venugopal S. M.

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Anterior Knee Pain ◽

Intervention Group ◽

Control Group ◽

Significant Difference ◽

Total Knee ◽

Anterior Knee

Background: Anterior knee pain (AKP) following total knee arthroplasty (TKA) is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.Methods: A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.Results: The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p<0.05). Western Ontario and McMaster Universities osteoarthritis index scores were significantly better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.Conclusions: There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.

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Anterior Knee Pain and Oedema-Like Changes of The Suprapatellar Fat Pad: Correlation of The Symptoms with MRI Findings

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210129114110 ◽

2021 ◽

Vol 17 ◽

Author(s):

Yasemin Kucukciloglu ◽

Ozum Tuncyurek

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Signal Intensity ◽

Control Group ◽

Fat Pad ◽

Mri Findings ◽

Relative Signal Intensity ◽

Significant Difference ◽

Anterior Knee ◽

Fat Pads

Objective: To evaluate the role of oedema like changes of the suprapatellar fat pad in the development of anterior knee pain. Methods: Total 156 knee MRIs of 150 patients from December 2015 to July 2019 were retrospectively evaluated by a radiologist with 13 years of MRI experience for the configuration of the suprapatellar fat pads. Population was divided into two groups according to referring physicians’ notes for presence of anterior knee pain. The study group consisted of the patients with complaints of anterior knee pain. The control group consisted of patients without anterior knee pain. Maximum craniocaudal, anteroposterior and oblique diameters and relative signal intensity indexes of the suprapatellar fat pads were measured and compared between the groups. Configurations of the fat pads were recorded (triangular shaped vs convex posterior bordered suprapatellar fat pads), and measurements of the triangular shaped and convex posterior bordered suprapatellar fat pads were compared. Student t test was used for statistical analysis. Statistically significant differences and correlations were defined as p<0.05. Results: The diameters and relative signal intensity indexes of the fat pads showed no significant difference between the groups (p=0.588, 0.744, 0.874 and 0.201, respectively). Anteroposterior and oblique diameters and relative signal intensity indexes of the suprapatellar fat pads were correlated with convex posterior border (p=0.001, 0.003 and 0.000, respectively). Conclusion: Oedema-like changes of the suprapatellar fat pad seen at knee MRIs are correlated with the configuration of the fat pad, but are rarely associated with anterior knee pain.

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Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

10.21203/rs.2.15386/v2 ◽

2020 ◽

Author(s):

Yifan Huang ◽

Yuhang Gao ◽

Lu Ding ◽

Bo Liu ◽

Jianguo Liu ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Anterior Knee Pain ◽

Implant Design ◽

Control Group ◽

Patellar Resurfacing ◽

Design Modification ◽

Total Knee ◽

Anterior Knee

Abstract Background : The incidence of patient dissatisfaction due to multiple factors, especially anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA), remain a concern. Improvements in the femoral component of the traditional prosthesis could reduce the incidence of these complications in TKA performed with patellar resurfacing. This study aimed to explore whether TKA without patellar resurfacing benefits from this modification in femoral implant design with regard to AKP and patellar crepitus. Methods : Sixty-two patients (85 knees) who underwent TKA with the modern prosthesis and 62 age- and sex-matched patients (90 knees) fitted with the traditional prosthesis were enrolled in this study. The incidence of AKP and patellar crepitus, and Knee Society Score (KSS) was recorded. Statistical analyses were performed to determine whether there were differences between the groups. Results: The incidence of AKP was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (4.7% vs. 13.3% [ p =0.048] and 3.5% vs. 13.3% [ p =0.021], respectively). The incidence of patellar crepitus was significantly lower in the study group compared with the control group at the 3-month and 1-year follow-ups (15.3% vs. 34.4% [ p =0.004] and 10.6% vs. 28.9% [ p =0.002], respectively). There was no significant difference in KSS between the groups. Conclusion : Results revealed that TKA without patellar resurfacing benefited from the femoral implant design modification with regard to AKP and patellar crepitus. These data may be meaningful to surgeons who use the modern prosthesis and omit resurfacing the patella in their patients. Keywords : total knee arthroplasty, femoral component, prosthesis design, anterior knee pain, patellar crepitus

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Bioelectrical Activity of Vastus Medialis and Rectus Femoris Muscles in Recreational Runners with Anterior Knee Pain

Journal of Human Kinetics ◽

10.2478/hukin-2018-0065 ◽

2019 ◽

Vol 66 (1) ◽

pp. 81-88 ◽

Cited By ~ 3

Author(s):

Piotr Gawda ◽

Michał Ginszt ◽

Magdalena Zawadka ◽

Maria Skublewska-Paszkowska ◽

Jakub Smołka ◽

...

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Rectus Femoris ◽

Control Group ◽

Common Source ◽

Median Frequency ◽

Vastus Medialis ◽

Bioelectric Activity ◽

Recreational Runners ◽

Anterior Knee

Abstract Patellofemoral pain syndrome (PFPS), the most common source of knee pain among physically active individuals, is defined as anterior knee pain involving the patella and retinaculum that excludes other intraarticular and peri-patellar pathology. Differences in the activation and endurance of the quadriceps components, causing an imbalance in the forces controlling patellar tracking during flexion and extension in the knee joint, appear to be the most commonly reported risk factors for PFPS. The aim of this study was to determine the differences in bioelectric activity of vastus medialis and rectus femoris muscles during half knee bend position in runners with PFPS. The sample comprised 20 recreational runners (15 males, 5 females; aged 27 ± 5 years) reporting knee pain and diagnosed with PFPS. The age- and sex-matched control group consisted of recreational runners who did not report knee pain. The myon electromyographic system was used to determine the changes in the electromyographic median frequency during a half squat position. The decrease in the median frequency of vastus medialis and rectus femoris muscles was significantly greater in runners with PFPS in comparison to the control group (p < 0.01 for right and left vastus medialis and right rectus femoris; p < 0.05 for left rectus femoris). There is a relationship between knee pain related to PFPS and the imbalance of bioelectric activity of vastus medialis and rectus femoris muscles. Achieving the muscular balance within the thigh muscles can be an important factor in the rehabilitation process of PFPS.

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A censervative programme for treatment of anterior knee pain in adolescents

South African Journal of Sports Medicine ◽

10.17159/2413-3108/2008/v20i1a286 ◽

2009 ◽

Vol 20 (1) ◽

pp. 14 ◽

Cited By ~ 1

Author(s):

J Phillips ◽

MF Coetsee

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Rehabilitation Programme ◽

Control Group ◽

Test Results ◽

Before And After ◽

Post Test ◽

Anterior Knee ◽

Experimental Group

Objective. The purpose of this study was to determine the effectiveness of a 2½-week conservative rehabilitation programme in addressing anterior knee pain in adolescents. Design. Subjects were randomly allocated to a control group (N=12) and an experimental group (N=18). The experimental group was subjected to a 2½-week strength, flexibility and neuromuscular rehabilitation programme. Both groups were tested before and after the 2½ weeks and the experimental group also 1 month after the post-test. Results. The experimental group reported significant (p

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Comparative study of anterior knee pain after patelloplasty with and without circumferential denervation in a total knee arthroplasty

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v13i2.106 ◽

2019 ◽

Vol 13 (2) ◽

pp. 106-110

Author(s):

Ahmed Latteef Al-Shamari

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Anterior Knee Pain ◽

Statistical Significance ◽

Study Groups ◽

Control Group ◽

Before And After ◽

Total Knee ◽

Anterior Knee

Background: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery. Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient. Type of the study:Cross- sectional study. Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this prospective, hospital based study that was held at Al-Yarmouk Teaching Hospital in Baghdad from October 2012 to November 2016. These patients were divided into 2 groups, first group was composed of 19 patients who have TKA with patellar circumferential denervation by electrocautery with patelloplasty by removing peripheral osteophytes of patella , the second group of 16 patients were undergone TKA without denervation, but only patelloplasty. The second group was considered as the control group. Visual analogue scale (VAS) was used to evaluate pain pre and post operatively. The patient’s functional ability was assessed by knee society score (KSS) also before and after TKA for both groups and pain killer was given according to patients need. Results: All of the patients were followed for 12 months period. No drugs were used other than occasional use of pain killers in first month after operation for all patients in group one of study. On VAS scale, significant statistical difference in pre and post-operative scales were noticed between both groups of study. The Knee Society Scale (KSS) was showing a non- significant statistical significance between both study groups before and after TKA. ConclusionA: nterior knee pain can be reduced through the use of patelloplasty with circumferential denervation of patella byelectrocautery, compared with non- denervated procedure. Good clinical outcome was also present.

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Early Patellofemoral Function of Unilateral TKA with Medial Pivot Prostheses is Superior than with Conventional Posterior-Stabilized Prostheses

10.21203/rs.2.18123/v1 ◽

2019 ◽

Author(s):

Zhen Wang ◽

Yuqing Zhang ◽

Changrong Ding ◽

Xiaoyu Cai ◽

Liang Gao ◽

...

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Systematic Evaluation ◽

Control Group ◽

Study Group ◽

Posterior Stabilized ◽

Medial Pivot ◽

Group A ◽

Group B ◽

Anterior Knee

Abstract PurposeThe purpose of this study was to provide a systematic evaluation of the patellofemoral joint design of Medial Pivot Prosthesis, which incorporates a variety of “Patella-friendly” design features, by comparing clinical and radiographic results with another prosthesis. MethodsEarly clinical and radiographic results of patients who underwent unilateral TKA with Medial Pivot Prosthesis (The study group, including 126 cases) and conventional Posterior-Stabilized Prosthesis (The control group) were retrospectively compared. Postoperative complications, including anterior knee pain, maltracking, patellar clunk or crepitus (PCC), were evaluated.ResultsThe postoperative Kujala score and its improvement from baseline in the study group (Group A) were significantly higher than those in the control group(Group B). The range of motion (ROM) in group A, including the improvement in ROM, was significantly inferior to group B. In the 90-degree Merchant view, the patellar tilt in group A was smaller than that in group B. Two cases of PCC and 3 cases of anterior knee pain were noted in group A, and 9 cases and 6 cases, respectively, were observed in group B. The incidence of PCC was significantly lower in group A. There were no significant between-group differences in the patella tilt angle at 30 or 60° or in the postoperative patellar translation at 30, 60 or 90°. No between-group difference in posterior condyles angle (PCA) was observed. The KSS scores and WOMAC scores between the two groups were similar.ConclusionThe medial pivot prosthesis could achieve satisfactory outcomes with superior patellofemoral performance attributed to its “patella-friendly” design characteristics compared to the conventional posterior-stabilized prosthesis.

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A censervative programme for treatment of anterior knee pain in adolescents

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2008/v20i1a286 ◽

2008 ◽

Vol 20 (1) ◽

pp. 14

Author(s):

J Phillips ◽

MF Coetsee

Keyword(s):

Knee Pain ◽

Anterior Knee Pain ◽

Rehabilitation Programme ◽

Control Group ◽

Test Results ◽

Before And After ◽

Post Test ◽

Anterior Knee ◽

Experimental Group

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Ceramic Bone Graft Substitutes do not reduce donor-site morbidity in ACL reconstruction surgeries: a pilot study

SICOT-J ◽

10.1051/sicotj/2019013 ◽

2019 ◽

Vol 5 ◽

pp. 14

Author(s):

Naresh Dhanakodi ◽

Jai Thilak ◽

Jacob Varghese ◽

Krishnankutty Venugopal Menon ◽

Harikrishna Varma ◽

...

Keyword(s):

Bone Graft ◽

Acl Reconstruction ◽

Knee Pain ◽

Anterior Knee Pain ◽

Donor Site ◽

Donor Site Morbidity ◽

Control Group ◽

Study Group ◽

Bptb Graft ◽

Anterior Knee

Introduction:Anterior knee pain is a major problem following Bone-patellar-tendon-bone graft (BPTB) use in anterior cruciate ligament (ACL) reconstruction. We hypothesized that filling the donor defect sites with bone-graft substitute would reduce the anterior knee symptoms in ACL reconstruction surgeries.Material and Methods: Patients operated for ACL-deficient knee between March 2012 and August 2013 using BPTB graft were divided into two treatment groups. The patellar and tibial donor-site bony defects were filled-up with Hydroxyapatite–Bioglass (HAP:BG) blocks in the study group (n = 15) and no filler was used in the control group (n = 16). At 2 years, the clinical improvement was assessed using International Knee Documentation Committee (IKDC) score and donor-site morbidity was assessed by questionnaires and specific tests related to anterior knee pain symptoms.Results: Donor-site tenderness was present in 40% patients in the study group and 37.5% patients in the control group (p = 0.59). Pain upon kneeling was present in 33.3% patients in the study group and 37.5% patients in the control group (p = 0.55). Walking in kneeling position elicited pain in 40% patients in the study group and 43.8% in the control group (p = 0.56). The mean visual analogue score for knee pain was 3.0 in the study group and 3.13 in the control group, with no statistically significant difference (p = 0.68). Unlike control group, where a persistent bony depression defect was observed at donor sites, no such defects were observed in the study group.Conclusion:Filling the defects of donor sites with HAP:BG blocks do not reduce the anterior knee symptoms in patients with ACL reconstruction using autogenous BPTB graft.

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Correlation Between Trochlear Groove Depth and Patellar Position During Open and Closed Kinetic Chain Exercises in Subjects With Anterior Knee Pain

Journal of Applied Biomechanics ◽

10.1123/jab.28.3.335 ◽

2012 ◽

Vol 28 (3) ◽

pp. 335-342 ◽

Cited By ~ 5

Author(s):

Lílian Ramiro Felicio ◽

Marcelo Camargo Saad ◽

Rogério Ferreira Liporaci ◽

Augusto do Prado Baffa ◽

Antônio Carlos dos Santos ◽

...

Keyword(s):

Knee Pain ◽

Tilt Angle ◽

Anterior Knee Pain ◽

Kinetic Chain ◽

Pain Group ◽

Patellar Tilt ◽

Sulcus Angle ◽

Closed Kinetic Chain ◽

Anterior Knee ◽

Patellar Tilt Angle

The purpose of this study was to correlate the trochlear shape and patellar tilt angle and lateral patellar displacement at rest and maximal voluntary isometric contraction (MVIC) exercises during open (OKC) and closed kinetic chain (CKC) in subjects with and without anterior knee pain. Subjects were all women, 20 who were clinically healthy and 19 diagnosed with anterior knee pain. All subjects were evaluated and subjected to magnetic resonance exams during OKC and CKC exercise with the knee placed at 15, 30, and 45 degrees of flexion. The parameters evaluated were sulcus angle, patellar tilt angle and patellar displacement using bisect offset. Pearson’srcoefficient was used, withp< .05. Our results revealed in knee pain group during CKC and OKC at 15 degrees that the increase in the sulcus angle is associated with a tilt increase and patellar lateral displacement. Comparing sulcus angle, patellar tilt angle and bisect offset values between MVIC in OKC and CKC in the knee pain group, it was observed that patellar tilt angle increased in OKC only with the knee flexed at 30 degrees. Based on our results, we conclude that reduced trochlear depth is correlated with increased lateral patellar tilt and displacement during OKC and CKC at 15 degrees of flexion in people with anterior knee pain. By contrast, 30 degrees of knee flexion in CKC is more recommended in rehabilitation protocols because the patella was more stable than in other positions.

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