TY - JOUR
T1 - Adolescent patellofemoral pain
T2 - Implicating the medial patellofemoral ligament as the main pain generator
AU - Luhmann, Scott J.
AU - Schoenecker, Perry L.
AU - Dobbs, Matthew B.
AU - Eric Gordon, J.
PY - 2008
Y1 - 2008
N2 - Purpose: The purpose of this study is to define the clinical presentation of adolescent patellofemoral pain. Methods: A review was completed of all patients with patellofemoral pain at a children's hospital sports clinic over a 3-year period. Results: One hundred and one patients (91 female) with 136 symptomatic knees were identified. Mean age was 14.4 years. Knee pain was localized to the anteromedial or anterior region of the knee in 96% of patients and was typically produced with running (94%), jumping (92%) and stair use (69%). On physical examination there was usually a non antalgic gait (99%), no patellofemoral crepitation (98%), normal lower extremity angular (84%) and rotational alignment (94%), with no foot malalignment (>97%). The medial patellofemoral ligament (MPFL) was the most palpably tender area of the knee in 98% of patients. During "lateral apprehension " testing, 89% had pain at the MPFL, but not true apprehension. A "J-sign " was present at terminal knee extension in 65%. Mean Q-angle was 18.7°. Means of all radiographic measures were within normal ranges. Conclusion: The prototypical patient had anterior/anteromedial knee pain of insidious onset during running and jumping. The most consistent physical findings were focal tenderness at the MPFL, positive terminal J-sign, and an elevated Q-angle. Most patients required only nonsurgical treatments, but 18% underwent surgical interventions for persistent pain.
AB - Purpose: The purpose of this study is to define the clinical presentation of adolescent patellofemoral pain. Methods: A review was completed of all patients with patellofemoral pain at a children's hospital sports clinic over a 3-year period. Results: One hundred and one patients (91 female) with 136 symptomatic knees were identified. Mean age was 14.4 years. Knee pain was localized to the anteromedial or anterior region of the knee in 96% of patients and was typically produced with running (94%), jumping (92%) and stair use (69%). On physical examination there was usually a non antalgic gait (99%), no patellofemoral crepitation (98%), normal lower extremity angular (84%) and rotational alignment (94%), with no foot malalignment (>97%). The medial patellofemoral ligament (MPFL) was the most palpably tender area of the knee in 98% of patients. During "lateral apprehension " testing, 89% had pain at the MPFL, but not true apprehension. A "J-sign " was present at terminal knee extension in 65%. Mean Q-angle was 18.7°. Means of all radiographic measures were within normal ranges. Conclusion: The prototypical patient had anterior/anteromedial knee pain of insidious onset during running and jumping. The most consistent physical findings were focal tenderness at the MPFL, positive terminal J-sign, and an elevated Q-angle. Most patients required only nonsurgical treatments, but 18% underwent surgical interventions for persistent pain.
KW - Anterior knee pain
KW - Lateral retinacular release
KW - Nonoperative treatment
KW - Patellofemoral pain
UR - http://www.scopus.com/inward/record.url?scp=50149097236&partnerID=8YFLogxK
U2 - 10.1007/s11832-008-0104-2
DO - 10.1007/s11832-008-0104-2
M3 - Article
C2 - 19308554
AN - SCOPUS:50149097236
SN - 1863-2521
VL - 2
SP - 269
EP - 277
JO - Journal of Children's Orthopaedics
JF - Journal of Children's Orthopaedics
IS - 4
ER -