Anterior knee pain: Remember to look up and be aware of structural anomalies

Unfortunately, when an orthopedic surgeon sees a patient with anterior knee pain in the office, he or she normally only focuses on the knee. If we do this we are making a big mistake.

We must remember to “look up” and evaluate the pelvis and proximal femur as well as psychological factors that modulate the pain to fully understand what is happening and to be able to solve this challenging problem. Moreover, we must be aware of structural anomalies (i.e., chondropathy and patellofemoral malalignment – patellar tilt and lateral patellar subluxation) given the correlation between structural anomalies and anterior knee pain is low.

Structural anomalies should not give us a “green light” to correct them surgically. In fact, in my experience, the worst cases of patients with anterior knee pain are secondary to a surgical procedure that aimed to correct structural anomalies that were possibly not the cause of the pain and disability.

To read the full Patellofemoral Update blog from Vicente Sanchis-Alfonso, MD, PhD, click here.