Anterior knee pain is a broad non specific label given to people experiencing pain over the front of the knee. It may have a non specific cause, or be due to a variety of conditions including; Patellofemoral pain syndrome, patella tendinopathy, infrapatellar fat pad syndrome, osteoarthritis, pre-patellar/ infrapatellar bursitis, patella instability, Osgood-schlatter disease, Sinding-Larsen-Johansson disease, or an articular cartilage injury or defect as examples.
Nearly 40% of those with patella-femoral pain continue to experience symptoms after 2 years, which is associated with frequent use of pain killers, lowering of physical activity levels and low quality of life. Evidence has shown in controlled trials that education in combination with Physiotherapy is most likely to be effective at 3 months. At 12 months education alone has shown to be comparable to Physiotherapy. Education of the patient is of fundamental importance. All treatment interventions are superior to a ‘wait and see’ approach.
Signs of non specific anterior knee pain
- Young/ middle aged
- Female > Male
- There is no feature specific to anterior knee pain
- Range of movement is usually normal
- No effusion
- Gradual onset of pain
- Possibly increased BMI
Tests
- Pain on squatting
- Pain going down stairs more than up usually
- Possible pain on compression
- Pain on kneeling
Management
- Physiotherapy should be the main stay of treatment
- Activity modification
- Offer advice on core treatments
- Activity and exercises
- Interventions to achieve weight loss if the person is Overweight
- Oral Analgesics
- Orthopaedic referral is not required
