Patellofemoral Pain in Adolescence and Adulthood: Same Same, but Different?

Abstract

The mainstay of patellofemoral pain (PFP) treatment is exercise therapy, often in combination with adjunct treatments such as patient education, orthoses, patella taping and stretching, making the intervention multimodal in nature. The vast majority of randomised controlled trials among patients with PFP have investigated the effect of treatment among adults (>18 years of age). So, while systematic reviews and meta-analyses provide evidence-based recommendations for treating PFP, these recommendations are largely based upon the trials in adults. In the present article, we have summarised the findings on the efficacy of multimodal treatment (predominantly exercise) from the three largest trials concerning patients with PFP, focusing on the long-term success-rate 1 year after receiving multimodal treatment, and with a particular focus on the success rate across the different age groups, including both adolescents, young adults and adults. The results of this paper show that there appears to be a difference in the success rate between adolescents and adults, despite providing similar exercise treatment and having similar exercise compliance. While PFP may present in a similar fashion in adolescence and adults, it may not be the same underlying condition or stage, and different treatments may be required. Collectively, this highlights the importance of increasing our understanding of the underlying pathology, pain mechanisms and why treatment may-or may not-work in adolescents and adults with PFP.

Characteristics and Outcome of Patellofemoral Pain in Adolescents: Do They Differ From Adults?

“…In contrast to our findings, Rathleff et al 13 showed that the success rate of treatment differed between adult and adolescent patients with PFP who performed similar exercises and had comparable compliance. Others have also reported lower success rates (29%-53%) in adolescent patients with PFP.…”

“…13 As a consequence, the importance of getting a better understanding of the pathology and prognosis in both adolescents and adults was emphasized. The present study investigated potential differences in patient characteristics, reported symptoms, and reported pain and function at 1-year follow-up between adolescents and adults with PFP.…”

Comparação do nível de dor femoropatelar, atividade física e qualidade de vida entre adolescentes do sexo feminino e masculino

“…Embora a prevalência da DFP seja maior em mulheres e em adolescentes do sexo feminino [10,23], o presente estudo mostra que adolescentes do sexo masculino com DFP possuíam maiores níveis de dor autorreportada. Isso pode indicar que, embora as adolescentes do sexo feminino sejam mais acometidas pela DFP, os adolescentes do sexo masculino apresentam maior severidade dos sintomas.…”

“…De acordo com Rathleff et al [10], mais de 1500 artigos científicos já foram publicados na área da DFP nos últimos 30 anos e menos de 5% desses estudos envolvem adolescentes. Na maioria dos casos, adolescentes com DFP apresentam sintomatologia de mais de três anos [11], e apenas 5% reportam duração da dor por menos de seis meses [12].…”

Evaluation and management of knee pain in young athletes: overuse injuries of the knee

“…Idiopathic anterior knee pain, also described as patellofemoral pain syndrome, refers to non-specific, vague, mostly activity related anterior knee pain and is the most common cause of knee pain in adolescents (8)(9)(10)(11)(12). Gorman McNerney and Arendt state that idiopathic anterior knee pain affects around 30% of the adolescent population (13).…”