Atraumatic and traumatic patellofemoral pain: comparison of clinical and biomechanical features

Author(s)

Helder dos Santos Lopes

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2023-09-05.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2023-07-07
• Advisor: Fábio Mícolis de Azevedo

Abstract

Introduction: Patellofemoral pain (PFP) is characterized by retro- or peripatellar pain, exacerbated by activities that overload the patellofemoral joint. The vast majority of PFP studies are performed on individuals with PFP without a history of knee trauma (atraumatic PFP). However, evidence points to a high prevalence of PFP symptoms after traumatic events in the knee (traumatic PFP), which may be related to worse levels of function and quality of life of affected individuals. However, due to the lack of investigations in individuals with traumatic PFP, little is known about what clinical and biomechanical impairments may be present in individuals with traumatic PFP. Objective: The main objective of this study was to compare clinical and biomechanical variables between individuals with traumatic PFP, atraumatic PFP and asymptomatic individuals with and without a history of knee traumas. Materials and methods: This is a cross-sectional observational study, divided into two collection days. On the first day, demographic data, clinical parameters and biomechanical variables were evaluated during a landing task. On the second day, psychological factors (i.e., kinesiophobia), and the peak torques of the knee extensors and flexors and hip abductors were evaluated. Independent t-tests were used to compare pain-related data. The Kruskal-Wallis test was used to compare demographic data. Generalized linear models (GzLM) were used to compare clinical and biomechanical variables between groups. Results: There were no significant differences between PFP groups for pain levels and duration of symptoms. Individuals with traumatic PFP have lower self-reported function, indicative of greater kinesiophobia and greater biomechanical impairments in the hip and knee during the landing task when compared to individuals from other groups. Conclusion: Taken together, these findings seem to suggest cumulative effects of trauma on PFP symptoms, and indicate that individuals with traumatic PFP may represent a characteristic subgroup of PFP. In this sense, it is recommended that individuals with traumatic PFP be evaluated and treated in a specific way. (AU)

• FAPESP's process: 21/09393-1 - Clinical and biomechanical characterization of post-traumatic patellofemoral pain: comparison with asymptomatic and insidious-onset patellofemoral pain
• Grantee: Helder dos Santos Lopes
• Support Opportunities: Scholarships in Brazil - Master