scholarly journals The development of an evidence-based clinical checklist for the diagnosis of anterior knee pain

2017 ◽  
Vol 73 (1) ◽  
Author(s):  
Dominique C. Leibbrandt ◽  
Quinette Louw
Keyword(s):  
Knee Pain ◽  
Systematic Reviews ◽  
Anterior Knee Pain ◽  
Pain Syndrome ◽  
Stair Climbing ◽  
Tilt Test ◽  
Evidence Based ◽  
Duration Of Symptoms ◽  
Prolonged Sitting ◽  
Anterior Knee

Background: Anterior knee pain (AKP) or patellofemoral pain syndrome is common and may limit an individual’s ability to perform common activities of daily living such as stair climbing and prolonged sitting. The diagnosis is difficult as there are multiple definitions for this disorder and there are no accepted criteria for diagnosis. It is therefore most commonly a diagnosis that is made once other pathologies have been excluded. Objectives: The aim of this study was to create an evidence-based checklist for researchers and clinicians to use for the diagnosis of AKP. Methods: A systematic review was conducted in July 2016, and an evidence-based checklist was created based on the subjective and objective findings most commonly used to diagnose AKP. For the subjective factors, two or more of the systematic reviews needed to identify the factor as being important in the diagnosis of AKP. Results: Two systematic reviews, consisting of nine different diagnostic studies, were identified by our search methods. Diagnosis of AKP is based on the area of pain, age, duration of symptoms, common aggravating factors, manual palpation and exclusion of other pathologies. Of the functional tests, squatting demonstrated the highest sensitivity. Other useful tests include pain during stair climbing and prolonged sitting. The cluster of two out of three positive tests for squatting, isometric quadriceps contraction and palpation of the patella borders and the patella tilt test were also recommended as useful tests to include in the clinical assessment. Conclusion: A diagnostic checklist is useful as it provides a structured method for diagnosing AKP in a clinical setting. Research is needed to establish the causes of AKP as it is difficult to diagnose a condition with unknown aetiology.

Anterior Knee-Pain Syndrome

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

scholarly journals Arthroscopic Lateral Retinacular Ligament Release in Patellofemoral Pain Syndrome

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.

scholarly journals Reliability of clinical methods in evaluating patellofemoral pain syndrome with malalignment

2017 ◽  
Vol 3 (3) ◽  
pp. 334
Author(s):  
Arjun R. H. H. ◽  
Rama Kishan ◽  
Dhillon M. S. ◽  
Devender Chouhan
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Patellar Instability ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Step Test ◽  
Clinical Test ◽  
Clinical Tests ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> Diagnosis of patellofemroal pain syndrome has been challenging due to lack of clinical test with better sensitivity and specificity, axial imaging has been considered as the standard modality for evaluation. Patients with anterior knee pain because of patellofemoral pain syndrome can be sub-grouped as those with or without radiological positive parameter for patellar maltracking.  The aim of the present study was to evaluate reliability of clinical tests in two subgroups of patients presenting with patellofemoral pain syndrome<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> 45 knees with anterior knee pain without any episode of patellar instability were evaluated clinically using four standard tests (patellar apprehension test (PAT), eccentric step test (EST), active instability test (AIT) and Waldron’s test. On the basis of CT scan finding (at least one positive radiological parameter of instability) 28 knees were categorized in Group A (potential patellar instability group) and 17 knees in Group B (PFPS).<strong></strong></p><p class="abstract"><strong>Results:</strong> All patients with 3 or more than three clinical test positive were cases with potential patellofemroal instability except two. Whereas other true patellofemroal pain patients all except 2 were have less than 3 positive clinical tests<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Clinical test have more diagnostic accuracy in evaluating anterior knee pain due to potential patellofemroal instability in comparison to patellofemroal pain without radiological instability<span lang="EN-IN">.</span></p>

Efficacy of Kinesio Taping and McConnell Taping Techniques in the Management of Anterior Knee Pain

2020 ◽  
Vol 29 (1) ◽  
pp. 79-86
Author(s):  
Rumit S. Kakar ◽  
Hilary B. Greenberger ◽  
Patrick O. McKeon
Keyword(s):  
Knee Pain ◽  
Visual Analog Scale ◽  
Anterior Knee Pain ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Drop Jump ◽  
Analog Scale ◽  
Kinesio Taping ◽  
Anterior Knee

Context: Anterior knee pain also known as patellofemoral pain syndrome is a frequently encountered musculoskeletal disorder that worsens with activity. The multifactorial etiology of patellofemoral pain syndrome alters lower-extremity mechanics, increasing patellofemoral joint stresses during weight-bearing tasks. Kinesio and McConnell tapings are often incorporated into the treatment, but their efficacy is still unclear. Objective: To test the efficacy of Kinesio taping, McConnell taping, and sham taping in improving knee mechanics and reducing pain during activity. Design: Cross-sectional design. Setting: Clinical biomechanics laboratory. Participants: Ten participants (age: 20.3 [1.5] y, height: 169.9 [10.4] cm, and mass: 70.17 [13.1] kg) with anterior knee pain and no history of trauma. Intervention: Three trials each of squat, drop jump, and step-down tasks with 3 taping conditions in a counterbalanced order. Main Outcome Measures: Two-dimensional motion capture data of lower-extremities in frontal and sagittal planes were recorded and analyzed using 3 iPads and Spark Motion® application. Pooled effect sizes (Hedges’ g), 95% confidence intervals, and repeated-measures analysis of variance (P < .05) compared baseline and taping conditions during exercises for pain Visual Analog Scale and knee flexion in all exercises, hip abduction during step-down and drop jump, frontal plane projection during step-downs, and knee translation in sagittal plane during squats. Results: Significant reductions in Visual Analog Scale were recorded during squats between tapes (F2.505,12.867 = 3.407, P = .04, Hedges’ g = −0.70). Pairwise comparison showed a decrease in Visual Analog Scale for sham taping (mean difference = 1.14 cm, P = .01) and Kinesio taping (mean difference = 1.54 cm, P = .02) compared with baseline during squats. Conclusions: A variety of taping methods can potentially reduce perceived pain in individuals with patellofemoral pain syndrome, allowing clinicians to perform rehabilitation exercises. Sensory effects associated with short-term taping may be sufficient enough to modify knee pain acutely by afferent input blocking nocioceptive pain before the participants could adapt. Most interestingly, the sham taping technique demonstrated promise for enhancing functional outcomes, depending on the length of the tape and area covered.

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