What sports medicine practitioners should know about imaging for femoro-patellar pathologies

2020 ◽  
Vol 68 (1) ◽  

Clinical imaging in patellofemoral disorders is fundamental for the understanding of the pathology, and to find the adequate treatment option. Anatomical risk factors such as trochlear dysplasia, patella alta, lateralized tibiale tubercle (measured by the tibiale tubercle trochlear groove distance), torsional or coronal lower limb alignment that are the origine of patellar maltracking or even patellar dislocation, can be assessed with high reliability on conventional radiographs combined with MR imaging. The conservative and surgical treatment will highly rely on these findings. The importance of clinical imaging in unspecific anterior knee pain is less clear. It is mostly performed to exclude structural injuries, however is rarely reliable to diagnose the painful structure. Critical appraisal of morphological risk factors is necessary especially in the treatment of anterior knee pain, since fortuitous pathological findings are frequent.

Clinical imaging in patellofemoral disorders is fundamental for the understanding of the pathology, and to find the adequate treatment option. Anatomical risk factors such as trochlear dysplasia, patella alta, lateralized tibiale tubercle (measured by the tibiale tubercle trochlear groove distance), torsional or coronal lower limb alignment that are the origine of patellar maltracking or even patellar dislocation, can be assessed with high reliability on conventional radiographs combined with MR imaging. The conservative and surgical treatment will highly rely on these findings. The importance of clinical imaging in unspecific anterior knee pain is less clear. It is mostly performed to exclude structural injuries, however is rarely reliable to diagnose the painful structure. Critical appraisal of morphological risk factors is necessary especially in the treatment of anterior knee pain, since fortuitous pathological findings are frequent.


2021 ◽  
Author(s):  
Manato Horii ◽  
Ryuichiro Akagi ◽  
Sho Takahashi ◽  
Shotaro Watanabe ◽  
Yuya Ogawa ◽  
...  

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.


2000 ◽  
Vol 28 (4) ◽  
pp. 480-489 ◽  
Author(s):  
Erik Witvrouw ◽  
Roeland Lysens ◽  
Johan Bellemans ◽  
Dirk Cambier ◽  
Guy Vanderstraeten

10.17159/6090 ◽  
2019 ◽  
Vol 31 (1) ◽  
pp. 1-6
Author(s):  
S Kunene ◽  
S Ramklass ◽  
N Taukobong

Background: Various factors predispose athletes with Anterior Knee Pain (AKP) making a holistic assessment & rehabilitation inevitable. Due to minimal rehabilitation services in under-resourced communities, runners are likely to report poorer health outcomes compared to other communities. Objective: The purpose was to report on the prevalence and determine extrinsic risk factors for AKP among runners in under-resourced communities. Materials & Methods: This was a cross-sectional study which included a population of 347 runners. Convenience sampling was used to recruit 183 participants aged between 13 and 55 with no history of knee surgery, traumatic or degenerative knee conditions. Questionnaires were used to collect data on AKP prevalence, and extrinsic risk factors. The SPSS (version 25) was used to analyse the data. Data were presented as frequencies and percentages and the results from chi-square and logistic regression tests. Results: Forty percent (40%) of participants presented with AKP, particularly males (n=106, 58%), youth (n=94, 51%) and participants with 3–5 years of running experience (n=57, 31%). Anterior knee pain was associated with age (X2=6.484, p=0.039) and running experience (X2=8.39, p=0.04). The following extrinsic risk factors contributed to AKP significantly: training load (p=0.04, Odds ratio [OR]=1.23); warm-up (p=0.04, OR=1.23); shoe condition (p=0.04, OR=0.14) and running surface (p=0.05, OR=1.2).  Discussion & conclusions: A substantial presence of AKP and its extrinsic risk factors were found among participants. These outcomes suggest that extrinsic risk factors should also be considered when managing AKP among runners. Keywords: Patellofemoral pain, external risk factors, athletes, poor resourced communities.


2020 ◽  
Vol 68 (1) ◽  

Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.


Author(s):  
Oluwatoyosi B. A. Owoeye ◽  
Luz Palacios-Derflingher ◽  
Kati Pasanen ◽  
Tate HubkaRao ◽  
Preston Wiley ◽  
...  

This study aimed at evaluating the burden and risk factors of patellar and Achilles tendinopathy among youth basketball players. Patellar and Achilles tendinopathy were prospectively monitored in 515 eligible male and female youth basketball players (11–18 years) through a competitive season. Overall, the season prevalence of patellar tendinopathy was 19.0% (95% CI: 15.7–22.7%), 23.2% (95% CI: 18.6–28.2%) in males and 12.5% (95% CI: 8.3–17.9%) in females. The season prevalence of Achilles tendinopathy was 4.3% (95% CI: 2.7–6.4%), 4.1% (95% CI: 2.2–7.0%) in males and 4.5% (95% CI: 2.1–8.4%) in females. Median proportion of symptoms duration was 83% of average total weeks of basketball exposure for patellar tendinopathy and 75% for Achilles tendinopathy. Median time to patellar tendinopathy onset was 8 weeks for male players and 6 weeks for female players. Higher odds of patellar tendinopathy risk were seen in males (OR: 2.23, 95% CI: 1.10–4.69) and players with previous anterior knee pain had significantly elevated odds (OR: 8.5, 95% CI: 4.58–16.89). The burden and risk of patellar tendinopathy is high among competitive youth basketball players. Risk factors include sex and previous anterior knee pain. These findings provide directions for practice and future research.


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