Affiliates

Upstate Medical University

Upstate Medical University, Syracuse, New York

Anterior Knee Pain » Treatment

Treatment

Options

In the absence of these other disorders listed above, the diagnosis is anterior knee pain; the approach should be conservative directed toward the knee. An attempt to correct any other relevant factors in the limb that might be contributing to the problem:

  • Foot abnormalities – orthotics
  • Lack of flexibility – stretching

Conservative Management

Eliminate overuse, modify precipitating factors

  • assess training or activity program,
  • rest until the symptoms have settled for more than a week,
  • then a judicious and gradual return to sporting or training activities with ongoing strength and flexibility exercises

Physiotherapy: tailored to the individual as every patient represents a unique biomechanical entity

  • treatment of any inflammation that is present,
  • strengthening of quadriceps (with overtraining of the vastus medialis) and hamstring muscle groups
  • stretching any tight structures

Analgesics/antiinflammatories: modify symptoms to make life more tolerable, no effect on the unknown underlying condition

  • Bracing/patellar taping: may be tried; there is no statistical proof that they help in controlled studies, but they may help in some individual cases

If, after 3-6 months of conservative management, the patient is no substantially improved, surgery can be an option.

Operative Management

Diagnostic test

If the anterior knee pain continues without much improvement, the question must be asked: can surgery improve the situation? A diagnostic injection is performed. The patient is asked to perform an exercise test so as to provoke the pain; sometimes exercise is not necessary, the pain is always there. With the anterior knee pain present, the affected knee is injected under sterile conditions with 10 cc of long acting local anesthetic. No steroid, or other agent other than the anesthetic is given. If substantial relief of pain occurs, and is maintained for hours to days, then surgery may help this condition. This assumes that you have been carefully checked for other conditions that can mimic this problem.

Surgery

Outpatient arthroscopic surgery has been successful in treating this condition. This is the subject of current research by the Department of Orthopaedic Surgery, Upstate Medical University, Syracuse, NY.