Is it just a made up term for people who have failed to identify the specific pathology that is the actual cause of the patient’s patellofemoral symptoms?
In a packed room, at our recent CPD meeting, with c. 20+ of our physiotherapist colleagues in attendance, Mr Ian McDermott, Consultant Knee Surgeon facilitated a lively interactive debate.
Following lots of questions, practical assessment and evidenced by patient cases, the main conclusions were as follows:
- Useful imaging for patients with anterior knee pain can be:
- X-rays, particularly including patellar skyline views
- MRI (preferably 3T)
- Ultrasound: if looking for tendinopathies or at the fat pad
- CT, with 3D reconstruction and with special femoral views to assess trochlear morphology
- Physiotherapy is a crucial element of the treatment of pretty much every kind of patellofemoral issue, even if surgery is planned or even if it’s likely: appropriate physiotherapy may help the patient avoid the need for any actual surgery… but even if not, then pre-operative physio (‘Pre-hab’) will help the patient prepare better for their surgery and for the post-operative rehab that will be required afterwards, which will help them achieve a better outcome.
- Don’t forget the more rare potential causes of anterior knee pain, such as:
- Osgood Schlatters’ ossicles
- Fractures of the inferior pole of the patella
- Tumours
- Referred pain from the hip (especially in children) or from the back.
Anterior knee pain is not a diagnosis!
- ‘Patellofemoral Pain Syndrome’ is just a made-up term, which means that you simply haven’t yet indentified the actual cause(s) of the patient’s problem(s).
- You can’t fully / properly assess the patellofemoral joint without full appropriate imaging.
- Many (? most) patellofemoral problems are multifactorial.
The London Sports Orthopaedics Knee Team consists of:
- Mr Ian McDermott, Consultant Orthopaedic Surgeon & Managing Partner of London Sports Orthopaedics
- Mr Henry Atkinson, Consultant Orthopaedic Surgeon
- Mr Peter Hill, Consultant Orthopaedic Surgeon
- Mr Vipin Aspoa, Consultant Orthopaedic Surgeon
More information https://sportsortho.co.uk/specialists/
This event was one of a series of CPD events for our we run throughout the year for our allied healthcare professionals. For more information or to register for one of our events visit https://sportsortho.co.uk/events/ or contact our Marketing Manager, Mary Wolff-Ingham mary.wolff.ingham@sportsortho.co.uk
