Anterior knee pain refers to pain or discomfort experienced at the front of the knee, typically around or behind the kneecap (patella). There are several potential causes and conditions associated with anterior knee pain. Often a thorough assessment and well planned conservative treatment plan will help to improve the symptoms.
Patellofemoral Pain Syndrome (PFPS) also known as "runner's knee," is one of the most common causes of anterior knee pain. It involves pain and dysfunction around the patellofemoral joint, where the patella meets the femur. PFPS is often associated with overuse, muscle imbalances, abnormal patellar tracking, and biomechanical issues. Here the key is to avoid overuse and improve running style. Surgery is not indicated, unless there are clear structural abnormalities or patella instability.
Patellar Tendinopathy, also referred to as "jumper's knee," occurs due to degeneration or inflammation of the patellar tendon, which connects the patella to the tibia. It commonly affects athletes involved in running or jumping sports and activities, such as netball, soccer and volleyball.Conservative treatment for jumper's knee typically involves rest, activity modification, and the use of ice or cold therapy to reduce pain and inflammation. Supportive devices such as knee braces or straps may also be used to alleviate stress on the tendon during physical activities. If conservative measures fail to provide sufficient relief, surgical intervention may be considered. Surgical treatment for jumper's knee may involve removing damaged tissue, repairing the tendon, or realigning the patella.
Patellar instability is characterized by the patella sliding or dislocating from its normal position within the patellofemoral groove. It can cause acute pain, a feeling of instability, and recurrent patellar dislocations or subluxations. Structural abnormalities, muscle imbalances, or ligamentous laxity may contribute to this condition.
Synovial plica syndrome occurs when the synovial plica, a fold of synovial tissue within the knee joint, becomes irritated or inflamed. This can lead to anterior knee pain, clicking or snapping sensations, and occasionally knee locking or giving-way. In severe cases, when conservative measures fail to provide relief, surgical intervention may be necessary. This involves arthroscopic surgery, during which the irritated plica is removed or released to alleviate symptoms and restore normal knee function.
Knee bursitis involves inflammation of the bursae, which are small fluid-filled sacs that help reduce friction between tendons, ligaments, and bones around the knee joint. Prepatellar bursitis, located in front of the kneecap, can cause anterior knee pain, tenderness, and swelling. This condition often improved with Non-steroidal anti-inflammatory drugs (NSAIDs) but in refractory cases with a large fluid accumulation aspiration or even surgical debridement is needed.
Osteoarthritis: Anterior knee pain can be a symptom of knee osteoarthritis, a degenerative joint disease characterized by the breakdown of cartilage in the knee joint. Osteoarthritis may cause pain, stiffness, and functional limitations, particularly in the anterior aspect of the knee. With significant pain not alleviated by conservative measures, and the with end-stage bone-on-bone arthritis surgical intervention should be considered.
Fractures of the patella are due to acute direct trauma to the knee, such as a fall or impact. They cause localized pain, swelling, and difficulty with knee movement. Patellar fractures often require medical intervention, including immobilization or surgical fixation.
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