Anterior knee pain is one of the most common complaints fielded by sports medicine physicians and surgeons. The well-conducted study “Unilateral anterior knee pain is associated with increased patellar lateral position after stressed lateral translation” by Leal and colleagues attempts to correlate increased patellar mobility with isolated, unilateral anterior knee pain. Twenty-three patients presenting to their clinic, assuming no significant radiographic parameters of patellofemoral instability or clinical/radiologic manifestations of ligamentous or meniscal injury or osteoarthritis, underwent a full clinical evaluation and completed Porto Patella Testing Device (PPTD) examinations with non-weight-bearing MRI/CT testing. The PPTD allows radiographic measurements of lateral translation, as well as patellar tilt, by applying stress to a relaxed patella in different angles and direction.
The authors found significant increases in lateral translation under applied medial stress compared to the contralateral, asymptomatic knee (9.8 +/- 3.6 mm and 7.1 +/- 6.3 mm, respectively, P = .028). These results may shed more light into the Pandora’s box that is anterior knee pain and confirm that our clinical examinations are likely not sensitive enough to appreciate these subtle differences in patellar translation. However, it still remains unknown if this small difference in non-weight-bearing patellar translation has any bearing on long-term outcome or response (or lack thereof) to a focused course of nonoperative management.
Leal A, et al. Knee Surg Sports Traumatol Arthrosc. 2019;doi:10.1007/s00167-019-05601-4.
Michael J. Alaia, MD
Assistant professor of orthopedic surgery
Associate director, Sports Medicine Fellowship
Division of Sports Medicine
NYU Langone Medical Center
Disclosures: Alaia reports no relevant financial disclosures.