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LITERATURE REVIEW


13. Roos EM, Toksvig-Larsen S. Knee injury and Osteoarthritis Outcome Score (KOOS) – validation and comparison to the WOMAC in total knee replacement. Health and Quality Life Outcomes 2003;1:17 Ageberg E, Forssblad M, et al. Sex differences in patient-reported outcomes after anterior cruciate ligament reconstruction: data from the Swedish knee ligament register. American Journal of Sports Medicine 2010;38:1334–1342 15. Rathleff MS, Samani A, et al. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain. Medicine & Science in Sports & Exercise 2013;45:1730–1739 16. Collins NJ, Bisset LM, et al. Efficacy of nonsurgical interventions for anterior knee pain: systematic review and meta-analysis of randomized trials. Sports Medicine 2012;42:31–49 17. van Linschoten R, van Middelkoop M, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ 2009;339:b4074 18. Rathleff MS, Roos EM, et al. Early intervention for adolescents with


patellofemoral pain syndrome – a pragmatic cluster randomised controlled trial. BMC Musculoskeletal Disorders 2012;13:9 19. Ageberg E, Link A, Roos EM. Feasibility of neuromuscular training in patients with severe hip or knee OA: the individualized goal-based NEMEX-TJR training program. BMC Musculoskeletal Disorders 2010;11:126 20. Crossley K, Bennell K, et al. Physical therapy for patellofemoral pain – a randomized, double-blinded, placebo- controlled trial. American Journal of Sports Medicine 2002;30:857–865 21. Barton C, Balachandar V, et al. Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. British Journal of Sports Medicine 2014;48:417–424 22. Collins NJ, Crossley KM, et al. Predictors of short and long term outcome in patellofemoral pain syndrome: a prospective longitudinal study. BMC Musculoskeletal Disorders 2010;11:11 23. Blond L, Hansen L. Patellofemoral pain syndrome in athletes: a 5.7-year retrospective follow-up study of 250


KEY POINTS n PFP affects 6–7% of school-attending


adolescents between 15 and 19 years of age.


n PFP can be treated using a multimodal approach with the basis being exercise therapy.


n Tailor the load and difficulty of the exercises to the individual.


n Be aware of a high physical activity level and help the adolescent to modify it if needed.


n Exercise therapy is effective for some, but not all. n Exercises are unlikely to work if they are not performed.


n Would a couch-potato who is not involved in any type sport develop patellofemoral pain while lying on the couch?


n What is the rationale for using exercise therapy in the treatment of adolescent patellofemoral pain?


n What considerations do you take into account when treating an adolescent compared to an adult with patellofemoral pain?


n You see an adolescent football player in the clinic. It is obvious that he has poor hip and knee control during high-load football-specific tasks. He plays football five times per week and he has a football tournament coming up in 6 weeks. How would you balance and prioritise advice on modification of physical activity level and exercises for his poor hip and knee control?


www.sportEX.net Animation:


Patellofemoral joint motion and patellar tracking


athletes. Acta Orthopaedica Belgica 1998;64:393–400 24. Collins N, Crossley K, et al. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ 2008;337:a1735.


FURTHER RESOURCES 1. Measurement of isometric muscle strength in adolescents: Rathleff CR, Baird WN, et al. Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain--a cross-sectional population-based study. PLoS One 2013;13(8): e79153. (http://spxj.nl/1n1Ndqp) 2. Training load and progression/ regression exercises: Rathleff MS, Roos EM, et al. Early intervention for adolescents with patellofemoral pain syndrome--a pragmatic cluster randomised controlled trial. BMC Musculoskeletal Disorders 2012;13:9 (http://spxj.nl/1l014L0).


THE AUTHOR MICH


MICHAEL SKOVDAL RATHLEFF MHSC PHD


Michael is a physiotherapist and has a Masters degree in health science. Recently he completed his PhD studies on adolescent


patellofemoral pain. His research aims to (1) understand why some adolescents develop long-lasting severe knee pain, (2) identify risk factors for long-lasting severe knee pain among adolescents, and (3) how we best treat adolescent knee pain. A special interest is patellofemoral pain, which is the most common knee complaint among adolescents with an insidious onset of knee pain. In addition, Michael uses his time on translation of his research through teaching at schools as well as to general practitioners and physiotherapists.


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DISCUSSIONS


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