N E Lankhorst1, M van Middelkoop1, K M Crossley2, S M A Bierma-Zeinstra1, E H G Oei3, B Vicenzino2, N J Collins4. 1. Department of General Practice, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. 2. School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia. 3. Department of Radiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. 4. Department of Mechanical Engineering, The University of Melbourne, Melbourne, Victoria, Australia.
Abstract
BACKGROUND:Patellofemoral pain (PFP) has traditionally been viewed as self-limiting, but recent studies show that a large proportion of patients report chronic knee pain at long-term follow-up. We identified those patients with an unfavourable recovery ('moderate improvement' to 'worse than ever' measured on a Likert scale) and examined whether there is an association between PFP and osteoarthritis (OA) at 5-8-year follow-up. METHODS: Long-term follow-up data were derived from 2 randomised controlled trials (n=179, n=131). Patient-reported measures were obtained at baseline. Pain severity (100 mm visual analogue scale (VAS)), function (Anterior Knee Pain Scale (AKPS)) and self-reported recovery were measured 5-8 years later, along with knee radiographs. Multivariate backward stepwise linear regression analyses were used to evaluate the prognostic ability of baseline pain duration, pain VAS and AKPS on outcomes of pain VAS and AKPS at 5-8 years. RESULTS: 60 (19.3%) participants completed the questionnaires at 5-8-year follow-up (45 women, mean age at baseline 26 years) and 50 underwent knee radiographs. No differences were observed between responders and non-responders regarding baseline demographics, and 3-month and 12-month pain severity and recovery. 34 (57%) reported unfavourable recovery at 5-8 years. 48 out of 50 participants (98%) had no signs of radiographic knee OA. Multivariate models revealed that baseline PFP duration (>12 months; R(2)=0.22) and lower AKPS (R(2)=0.196) were significant predictors of poor prognosis at 5-8 years on measures of worst pain VAS and AKPS, respectively. SUMMARY AND CONCLUSION: More than half of participants with PFP reported an unfavourable recovery 5-8 years after recruitment, but did not have radiographic knee OA. Longer PFP duration and worse AKPS score at baseline predict poor PFP prognosis. Education of health practitioners and the general public will provide patients with more realistic expectations regarding prognosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
RCT Entities:
BACKGROUND:Patellofemoral pain (PFP) has traditionally been viewed as self-limiting, but recent studies show that a large proportion of patients report chronic knee pain at long-term follow-up. We identified those patients with an unfavourable recovery ('moderate improvement' to 'worse than ever' measured on a Likert scale) and examined whether there is an association between PFP and osteoarthritis (OA) at 5-8-year follow-up. METHODS: Long-term follow-up data were derived from 2 randomised controlled trials (n=179, n=131). Patient-reported measures were obtained at baseline. Pain severity (100 mm visual analogue scale (VAS)), function (Anterior Knee Pain Scale (AKPS)) and self-reported recovery were measured 5-8 years later, along with knee radiographs. Multivariate backward stepwise linear regression analyses were used to evaluate the prognostic ability of baseline pain duration, pain VAS and AKPS on outcomes of pain VAS and AKPS at 5-8 years. RESULTS: 60 (19.3%) participants completed the questionnaires at 5-8-year follow-up (45 women, mean age at baseline 26 years) and 50 underwent knee radiographs. No differences were observed between responders and non-responders regarding baseline demographics, and 3-month and 12-month pain severity and recovery. 34 (57%) reported unfavourable recovery at 5-8 years. 48 out of 50 participants (98%) had no signs of radiographic knee OA. Multivariate models revealed that baseline PFP duration (>12 months; R(2)=0.22) and lower AKPS (R(2)=0.196) were significant predictors of poor prognosis at 5-8 years on measures of worst pain VAS and AKPS, respectively. SUMMARY AND CONCLUSION: More than half of participants with PFP reported an unfavourable recovery 5-8 years after recruitment, but did not have radiographic knee OA. Longer PFP duration and worse AKPS score at baseline predict poor PFP prognosis. Education of health practitioners and the general public will provide patients with more realistic expectations regarding prognosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Thomas G Sutlive; Andrew Golden; Kristin King; William B Morris; John E Morrison; Josef H Moore; Shane Koppenhaver Journal: Int J Sports Phys Ther Date: 2018-06
Authors: Aldo Scafoglieri; Jona Van den Broeck; Stijn Willems; Rob Tamminga; Henk van der Hoeven; Yde Engelsma; Stijn Haverkamp Journal: BMC Musculoskelet Disord Date: 2021-05-15 Impact factor: 2.362
Authors: José Roberto de Souza Júnior; Pedro Henrique Reis Rabelo; Thiago Vilela Lemos; Jean-Francois Esculier; João Pedro da Silva Carto; João Paulo Chieregato Matheus Journal: PLoS One Date: 2021-05-12 Impact factor: 3.240
Authors: Erika K Zambarano; David M Bazett-Jones; Danilo de Oliveira Silva; Christian J Barton; Neal R Glaviano Journal: J Athl Train Date: 2022-01-01 Impact factor: 2.860
Authors: Lori A Bolgla; Michelle C Boling; Kimberly L Mace; Michael J DiStefano; Donald C Fithian; Christopher M Powers Journal: J Athl Train Date: 2018-09 Impact factor: 2.860