scholarly journals Anterior knee pain: uncommon aetiologies

2003 ◽  
Vol 59 (2) ◽  
Author(s):  
Q. Louw
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Clinical Presentation ◽  
Cruciate Ligament ◽  
Fat Pad ◽  
Intraosseous Pressure ◽  
Common Causes ◽  
The Common ◽  
Anterior Cruciate ◽  
Anterior Knee

The aim of this review is to inform clinicians of less common causes of anterior knee pain. Relatively less common conditions leading to anterior knee pain include infra-patellar contracture syndrome, conditions affecting the fat pad, saphenous nerve entrapment, prepatellar neuromas, increased intraosseous pressure of the patella, ganglions of the anterior cruciate ligament and cysts. The aetiology, clinical presentation, risk factors and management  of each condition are outlined. Due to the common occurrence of anterior knee pain clinicians must remain vigilant in assessing the cause of this clinical presentation.

scholarly journals Anterior Knee Pain After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712096108
Author(s):  
Fabiano da Silva Marques ◽  
Pedro Henrique Borges Barbosa ◽  
Pedro Rodrigues Alves ◽  
Sandro Zelada ◽  
Rodrigo Pereira da Silva Nunes ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Extension Deficit ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: Anterior knee pain is a frequent condition after anterior cruciate ligament reconstruction (ACLR), but its origin remains uncertain. Studies have suggested that donor site morbidity in autologous bone–patellar tendon–bone reconstructions may contribute to patellofemoral pain, but this does not explain why hamstring tendon reconstructions may also present with anterior pain. Purpose: To evaluate the prevalence of anterior knee pain after ACLR and its predisposing factors. Study Design: Case-control study; Level of evidence, 3. Methods: We evaluated the records of all patients who underwent ACLR between 2000 and 2016 at a private facility. The prevalence of anterior knee pain after surgery was assessed, and possible risk factors (graft type, patient sex, surgical technique, range of motion) were evaluated. Results: The records of 438 patients (mean age, 30 years) who underwent ACLR were analyzed. Anterior knee pain was found in 6.2% of the patients. We found an increased prevalence of anterior knee pain with patellar tendon graft, with an odds ratio of 3.4 ( P = .011). Patients who experienced extension deficit in the postoperative period had an odds ratio of 5.3 of having anterior pain ( P < .001). Anterior knee pain was not correlated with patient sex or surgical technique. Conclusion: The chance of having anterior knee pain after ACLR was higher when patellar tendon autograft was used compared with hamstring tendon graft, as well as in patients who experienced extension deficit in the postoperative period.

Infrapatellar Fat Pad Impingement: A Systematic Review

2017 ◽  
Vol 30 (07) ◽  
pp. 639-646 ◽  
Author(s):  
Jason Genin ◽  
Mhamad Faour ◽  
Prem Ramkumar ◽  
George Yakubek ◽  
Anton Khlopas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Clinical Presentation ◽  
Infrapatellar Fat Pad ◽  
Lateral Side ◽  
Imaging Findings ◽  
Fat Pad ◽  
Knee Pathology ◽  
Anterior Knee

AbstractInfrapatellar fat pad impingement represents a source of anterior knee pain that is often overlooked. Due to the scarcity of reports related to this disorder, we conducted a systematic review of the literature related to infrapatellar fat pad impingement in evaluating the following: (1) clinical presentation, (2) imaging, (3) management, and (4) clinical outcomes. A systematic review was conducted investigating all available primary literature related to the clinical presentation, imaging, management, and outcomes of infrapatellar fat pad impingement syndrome. A total of 15 studies (9 case reports, 1 case series, and 5 retrospective studies) comprising 167 patients met eligibility criteria for this review. Patients with infrapatellar fat pad impingement were found to most often present with anterior knee pain that worsened with activity, and was frequently associated with trauma. Anterior knee pain, tenderness to palpation over the patellar tendon, loss in terminal extension, and pain with direct pressure on the medial or lateral side of the patella with the knee extended was often found on examination. Although patients may have classic imaging findings on magnetic resonance imaging (localized edema of the infrapatellar fat pad, deep fluid-filled infrapatellar bursa, nonvisualization of clefts, fibrosis, and calcifications), not all patients had positive imaging findings, thus making infrapatellar fat pad impingement a clinical diagnosis. Treatment begins with nonoperative management, but in recalcitrant cases, patients can be surgically treated with arthroscopic fat pad resection. Most patients who undergo operative treatment report improvement or complete resolution of symptoms in terms of pain and range of motion, and are able to return to work. To the best of our knowledge, this is the first comprehensive review on infrapatellar fat pad impingement to better aid the orthopaedic surgeons in diagnosing, treating, and managing patient expectations for this often overlooked knee pathology.

scholarly journals Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Koshiro Shimasaki ◽  
Tomokazu Yoshioka ◽  
Akihiro Kanamori ◽  
Masashi Yamazaki
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
Case Reports ◽  
Cruciate Ligament ◽  
Proton Density ◽  
Valgus Knee ◽  
Mucoid Degeneration ◽  
Anterior Cruciate ◽  
Anterior Knee

Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. We report a rare case of a patient diagnosed with bilateral mucoid degeneration of the ACL with AKP and no limited joint range of motion (ROM). A 59-year-old man with spontaneous right AKP was admitted to our hospital. He first underwent arthroscopic resection of the thickened medial plica protruding far into the medial patellofemoral joint (PFJ) but felt little effectiveness thereafter. He then had an arthroscopic release of the lateral patellar retinaculum because of valgus knee and patellar instability, which resulted in only temporary improvement. Then, the AKP relapsed, this time with limitations in the ROM. Magnetic resonance imaging (MRI0 showed a diffuse, thickened ACL with a high inhomogeneous intensity in the T2-weighted and proton density weighted images and which looked similar to a celery stalk. Based on the patient’s history and MRI findings, we suspected mucoid degeneration of the ACL and subsequently performed arthroscopic excision. At the same time, AKP appeared on the other side. Since the MRI demonstrated a similar celery stalk image as before, the same operation was performed on this side, as well. Finally, AKP and the limitation of the ROM were relieved approximately one month after surgery. Due to the patient only suffering from AKP with a preserved ROM, it took about 14 months to diagnose this disease. It should, therefore, always be considered in cases of AKP alone.

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