COMMON SPORTS MEDICINE CONDITIONS

Anterior Knee Pain

Location

As the patella (kneecap) tilts and rotates, its underside makes contact with the femur producing pain in this anterior region. Amongst many causes, repetitive contact that leads to anterior knee pain may result from anatomical misalignment or biomechanical, muscular and overuse trauma.

Symptoms

The pain that results from a pressure overload between the patella and its various contact points with the femur may affect both inactive patients and the more athletic. Repetitive impact, for example running up steps, hills, hard and uneven surfaces, may initiate the condition but once developed even prolonged sitting may be painful.

Diagnosis

Detailed discussion with the patient should identify possible causes, many of which relate to some triggering event, particularly for athletes. Imaging with CT or MRI scans should help to identify unusual conditions such as osteochondritis dissecans if the pain fails to respond to several weeks of treatment. Physical examination may highlight poor hip alignment or deficiencies in, commonly, the "quads" that allow too much lateral movement of the patella. Aspects of the patient's training may also point towards aggravating factors.

Treatment

This will depend upon the symptoms experienced, the age and lifestyle of the patient. For benign knee disorders, a combination of analgesics, heat or ice treatment, strength and flexibility exercises, bracing and taping, or orthotics (suitable shoe support). Surgery may be considered as a last resort. For example, fraying of the retropatellar cartridge (chondromalacia) may be treatable with 'keyhole' surgery to smooth out the under surface of the patella.

Further help:

Knee anatomy
www.thewellingtonkneeunit.com/knee-problems.asp

Osteochondritis
www.thewellingtonkneeunit.com/Treatments-ChondralDamage.asp