Anterior knee pain: A review

Objective: To establish whether there is consensus in the areas of definition, classification, assessment, diagnostic tests, and management of anterior knee pain. Data sources: A Medline search for the years 1988-1995 was performed using the terms patellofemoral joint, knee joint and pain, injury and rehabilitation, and anterior knee pain. In addition, references from selected papers were examined. Study selection: A total of 77 references specifically related to anterior knee pain were reviewed in the areas of definition, classification, assessment, diagnostic tests, and management. Although a small number of these papers were analytic in their study design, most of the papers reviewed were descriptive. Data extraction: Definitive statements on anterior knee pain in the areas noted herein were extracted and summarized. Similar statements were then grouped as indicative of general consensus. Independent and divergent statements were also summarized for each area of anterior knee pain. Data synthesis: Must of the literature related to anterior knee pain is subjective in nature and demonstrates limited consensus among experts. There is no generally accepted definition or classification of anterior knee pain. There was some agreement on the assessment, use of diagnostic tests, and management of anterior knee pain, but there are no definitive or objective management outcome criteria. Conclusions: The scientific literature on anterior knee pain is sparse. This review supports a need for the development of consensus guidelines for anterior knee pain. A consensus approach to anterior knee pain could result in the more efficient use of high-yield diagnostic tests, the use of more effective and standardized protocols for assessment and treatment, increased patient satisfaction, and recommendations on fitness counseling and early prevention.