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PATELLOFEMORAL AĞRI SENDROMLU HASTALARDA MODİFİYE EDİLEBİLİR RİSK FAKTÖRLERİNİN ARAŞTIRILMASI

Year 2022, Volume: 55 Issue: 1, 13 - 17, 30.04.2022
https://doi.org/10.20492/aeahtd.933162

Abstract

AMAÇ: Patellofemoral ağrı sendromu, özellikle fiziksel olarak aktif genç bireylerde sık görülen bir diz problemidir. Hastaların hem yaşam kalitesini hem de fonksiyonel aktivitelerini olumsuz etkiler. Bu çalışmanın amacı, önleyici müdahalelerin geliştirilmesine yardımcı olmak için araştırmacılara ve klinisyenlere patellofemoral ağrı sendromu için değiştirilebilir risk faktörleri hakkında bilgi sağlamaktır.

GEREÇ VE YÖNTEM: Çalışmaya ön diz ağrısı şikayeti olan ve ardından patellofemoral ağrı sendromu tanısı alan 130 hasta ve ön diz ağrısı olmayan 100 sağlıklı birey dahil edildi. Tüm bireyler yumuşak dokularda kısalık, kas güçsüzlüğü, alt ekstremite dizilim bozuklukları, ağrı düzeyleri ve fonksiyonel düzeyler açısından değerlendirildi.

BULGULAR: Patellofemoral ağrı sendromlu hastalar ve asemptomatik bireyler yaş, cinsiyet ve vücut kitle indeksi açısından benzerdi. Patellofemoral ağrı sendromlu hastalar ile asemptomatik bireyler karşılaştırıldığında, J bulgusu, tek bacaklı atlama testi pozitifliği, kuadriseps atrofisi, trendelenburg testi pozitifliği, iliotibial bant gerginliği, patellar tilt, patellar hipermobilite, patellar kenar duyarlılığı, genu rekurvatum, bacak uzunluk farkı ve eksternal tibial torsiyon PFAS'lı hastalarda anlamlı olarak yüksekti (p <0.05).

SONUÇ: Patellofemoral ağrı sendromunun çok faktörlü doğası düşünüldüğünde, hastalığın gelişiminde çok sayıda risk faktörü rol oynayabilir. Birçok risk faktörü rapor edilmiş olsa da bunlardan sadece bazıları değiştirilebilir. Bu nedenle, patellofemoral ağrı sendromlu hastalarda bu değiştirilebilir risk faktörlerini araştırmanın, eğer varsa bunları düzeltmenin veya değiştirmenin mantıklı olduğunu düşünüyoruz.

Supporting Institution

YOK

References

  • Referans1. Piva SR, Fitzgerald K, Irrgang JJ, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskelet Disord. 2006; 31; 7:33.
  • Referans2. Boling M, Padua D, Marshall S, et al. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010; 20: 725-30.
  • Referans3. Akarcali İ, Turgay N, Erden Z, et al. Assessment of muscle strength and soft tissue tightness in patients with patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2000; 34: 23-7.
  • Referans4. Crossley K, Bennell K, Green S, et al. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002; 30: 857-65.
  • Referans5. van Linschoten R, van Middelkoop M, Berger MY, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ. 2009; 20: 339.
  • Referans6. Callaghan MJ, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Phys Ther Sport. 2007; 8: 37–43.
  • Referans7. Witvrouw E, Lysens R, Bellemans J, et al. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med. 2000; 28: 480-9.
  • Referans8. Haim A, Yaniv M, Dekel S, et al. Patellofemoral pain syndrome: validity of clinical and radiological features. Clin Orthop Relat Res. 2006; 451: 223-8.
  • Referans9. Liporaci RF, Saad MC, Felício LR, et al. Contribution of the evaluation of the clinical signals in patients with patellofemoral pain syndrome. Acta Ortop Bras. 2013; 21: 198-201.
  • Referans10. Kwon O, Yun M, Lee W. Correlation between intrinsic patellofemoral pain syndrome in young adults and lower extremity biomechanics. J PhyTher Sci. 2014; 26: 961.
  • Referans11. Post WR. Current concepts clinical evaluation of patients with patellofemoral disorders. J Arthr Rel Surg. 1999; 15: 841-51.
  • Referans12. Amis AA, Oguz C, Bull AM, et al. The effect of trochleoplasty on patellar stability and kinematics: a biomechanical study in vitro. J Bone Joint Surg Br. 2008; 90: 864-9.
  • Referans13. Pattyn E, Verdonk P, Steyaert A, et al. Vastus medialis obliquus atrophy: does it exist in patellofemoral pain syndrome? Am J Sports Med. 2011; 39: 1450-5.
  • Referans14. Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010; 29: 379-98.
  • Referans15. Messier SP, Davis SE, Curl WW, et al. Etiologic factors associated with patellofemoral pain in runners. Med Sci Sports Exerc. 1991; 23: 1008-15.
  • Referans16. Milgrom C, Finestone A, Eldad A, et al. Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits. J Bone Joint Surg Am. 1991; 73: 1041-3.
  • Referans17. Ageberg E, Zätterström R, Moritz U. Stabilometry and one-leg hop test have high test-retest reliability. Scand J Med Sci Sports. 1998; 8: 198-202.
  • Referans18. Davis IS, Powers CM. Patellofemoral pain syndrome: proximal, distal, and local factors, an international retreat. J Orthop Sports Phys Ther. 2010; 40: A1-16.
  • Referans19. Prins MR, van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Aust J Physiother. 2009; 55: 9-15.
  • Referans20. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003; 33: 639-46.
  • Referans21. Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006; 85: 234-43.
  • Referans22. White LC, Dolphin P, Dixon J. Hamstring length in patellofemoral pain syndrome. Physiotherapy. 2009; 95: 24-8.
  • Referans23. Puniello MS. Iliotibial band tightness and medial patellar glide in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1993; 17: 144-8.
  • Referans24. MacIntyre NJ, Hill NA, Fellows RA, et al. Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome. J Bone Joint Surg Am. 2006; 88: 2596-605.
  • Referans25. Moro-oka T, Matsuda S, Miura H, et al. Patellar tracking and patellofemoral geometry in deep knee flexion. Clin Orthop Relat Res. 2002; 394: 161-8.
  • Referans26. Petersen W, Ellermann A, Gösele-Koppenburg A, et al. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014; 22: 2264-74.
  • Referans27. Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006; 85: 234-43.
  • Referans28. Draper CE, Fredericson M, Gold GE, et al. Patients with patellofemoral pain exhibit elevated bone metabolic activity at the patellofemoral joint. J Orthop Res. 2012; 30: 209-13.
  • Referans29. Wilson NA, Press JM, Koh JL, et al. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am. 2009; 91: 558-66.
  • Referans30. Eckhoff DG, Brown AW, Kilcoyne RF, et al. Knee version associated with anterior knee pain. Clin Orthop Relat Res. 1997; 339: 152-5.
  • Referans31. Yercan HS, Taşkıran E. Patellofemoral eklem patolojisi ile alt ekstremite torsiyonel deformitelerinin ilişkisi. Ekl Hast Cer. 2004; 15: 71-5.
  • Referans32. Lowry CD, Cleland JA, Dyke K. Management of patients with patellofemoral pain syndrome using a multimodal approach: A case series. J Orthop Sports Phys Ther. 2008; 38: 691-702.
  • Referans33. Carlson M, Wilkerson J. Are differences in leg length predictive of lateral patello-femoral pain? Physiother Res Int. 2007; 12: 29-38.
  • Referans34. Kannus P, Niittymäki S. Which factors predict outcome in the nonoperative treatment of patellofemoral pain syndrome? A prospective follow-up study. Med Sci Sports Exerc. 1994; 26: 289-96.

INVESTIGATION OF MODIFIABLE RISK FACTORS IN PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME

Year 2022, Volume: 55 Issue: 1, 13 - 17, 30.04.2022
https://doi.org/10.20492/aeahtd.933162

Abstract

AİM: Patellofemoral pain syndrome is a knee problem, especially frequent in physically active young individuals. Patellofemoral pain syndrome is a set of symptoms rather than a specific diagnosis. It adversely affects both the quality of life and the functional activities of the patients. The aim of this study was to provide researchers and clinicians with an information concerning modifiable predictive variables for patellofemoral pain syndrome, to aid the development of preventative interventions.

MATERİAL AND METHOD: A total of 130 patients with complaints of anterior knee pain and subsequently diagnosed as having patellofemoral pain syndrome and 100 healthy individuals without anterior knee pain were included in the study. All individuals were assessed in terms of shortness in soft tissues, muscle weakness, lower extremity alignment disorders, pain levels and functional levels.

RESULTS: The patients with patellofemoral pain syndrome and asymptomatic subjects included in the study were similar in terms of age, gender and body mass index. In the comparison between patients with patellofemoral pain syndrome and asymptomatic subjects, J finding, one-legged hop test positivity, quadriceps atrophy, trendelenburg test positivity, iliotibial band tightness, patellar tilt, patellar hypermobility, patellar edge sensitivity, genu recurvatum, differences in leg length and external tibial torsion findings were significantly higher in patients with PFPS (p<0.05).

CONCLUSİON: Due to the multifactorial nature of patellofemoral pain syndrome, numerous risk factors may play a role in the development of patellofemoral pain syndrome. While many risk factors have been reported, only some of them may be modifiable. Therefore, we think it makes sense to investigate these modifiable risk factors in patients with patellofemoral pain syndrome and to correct or replace them, if any.

References

  • Referans1. Piva SR, Fitzgerald K, Irrgang JJ, et al. Reliability of measures of impairments associated with patellofemoral pain syndrome. BMC Musculoskelet Disord. 2006; 31; 7:33.
  • Referans2. Boling M, Padua D, Marshall S, et al. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scand J Med Sci Sports. 2010; 20: 725-30.
  • Referans3. Akarcali İ, Turgay N, Erden Z, et al. Assessment of muscle strength and soft tissue tightness in patients with patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2000; 34: 23-7.
  • Referans4. Crossley K, Bennell K, Green S, et al. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled trial. Am J Sports Med. 2002; 30: 857-65.
  • Referans5. van Linschoten R, van Middelkoop M, Berger MY, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ. 2009; 20: 339.
  • Referans6. Callaghan MJ, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Phys Ther Sport. 2007; 8: 37–43.
  • Referans7. Witvrouw E, Lysens R, Bellemans J, et al. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med. 2000; 28: 480-9.
  • Referans8. Haim A, Yaniv M, Dekel S, et al. Patellofemoral pain syndrome: validity of clinical and radiological features. Clin Orthop Relat Res. 2006; 451: 223-8.
  • Referans9. Liporaci RF, Saad MC, Felício LR, et al. Contribution of the evaluation of the clinical signals in patients with patellofemoral pain syndrome. Acta Ortop Bras. 2013; 21: 198-201.
  • Referans10. Kwon O, Yun M, Lee W. Correlation between intrinsic patellofemoral pain syndrome in young adults and lower extremity biomechanics. J PhyTher Sci. 2014; 26: 961.
  • Referans11. Post WR. Current concepts clinical evaluation of patients with patellofemoral disorders. J Arthr Rel Surg. 1999; 15: 841-51.
  • Referans12. Amis AA, Oguz C, Bull AM, et al. The effect of trochleoplasty on patellar stability and kinematics: a biomechanical study in vitro. J Bone Joint Surg Br. 2008; 90: 864-9.
  • Referans13. Pattyn E, Verdonk P, Steyaert A, et al. Vastus medialis obliquus atrophy: does it exist in patellofemoral pain syndrome? Am J Sports Med. 2011; 39: 1450-5.
  • Referans14. Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010; 29: 379-98.
  • Referans15. Messier SP, Davis SE, Curl WW, et al. Etiologic factors associated with patellofemoral pain in runners. Med Sci Sports Exerc. 1991; 23: 1008-15.
  • Referans16. Milgrom C, Finestone A, Eldad A, et al. Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits. J Bone Joint Surg Am. 1991; 73: 1041-3.
  • Referans17. Ageberg E, Zätterström R, Moritz U. Stabilometry and one-leg hop test have high test-retest reliability. Scand J Med Sci Sports. 1998; 8: 198-202.
  • Referans18. Davis IS, Powers CM. Patellofemoral pain syndrome: proximal, distal, and local factors, an international retreat. J Orthop Sports Phys Ther. 2010; 40: A1-16.
  • Referans19. Prins MR, van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Aust J Physiother. 2009; 55: 9-15.
  • Referans20. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003; 33: 639-46.
  • Referans21. Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006; 85: 234-43.
  • Referans22. White LC, Dolphin P, Dixon J. Hamstring length in patellofemoral pain syndrome. Physiotherapy. 2009; 95: 24-8.
  • Referans23. Puniello MS. Iliotibial band tightness and medial patellar glide in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther. 1993; 17: 144-8.
  • Referans24. MacIntyre NJ, Hill NA, Fellows RA, et al. Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome. J Bone Joint Surg Am. 2006; 88: 2596-605.
  • Referans25. Moro-oka T, Matsuda S, Miura H, et al. Patellar tracking and patellofemoral geometry in deep knee flexion. Clin Orthop Relat Res. 2002; 394: 161-8.
  • Referans26. Petersen W, Ellermann A, Gösele-Koppenburg A, et al. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014; 22: 2264-74.
  • Referans27. Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006; 85: 234-43.
  • Referans28. Draper CE, Fredericson M, Gold GE, et al. Patients with patellofemoral pain exhibit elevated bone metabolic activity at the patellofemoral joint. J Orthop Res. 2012; 30: 209-13.
  • Referans29. Wilson NA, Press JM, Koh JL, et al. In vivo noninvasive evaluation of abnormal patellar tracking during squatting in patients with patellofemoral pain. J Bone Joint Surg Am. 2009; 91: 558-66.
  • Referans30. Eckhoff DG, Brown AW, Kilcoyne RF, et al. Knee version associated with anterior knee pain. Clin Orthop Relat Res. 1997; 339: 152-5.
  • Referans31. Yercan HS, Taşkıran E. Patellofemoral eklem patolojisi ile alt ekstremite torsiyonel deformitelerinin ilişkisi. Ekl Hast Cer. 2004; 15: 71-5.
  • Referans32. Lowry CD, Cleland JA, Dyke K. Management of patients with patellofemoral pain syndrome using a multimodal approach: A case series. J Orthop Sports Phys Ther. 2008; 38: 691-702.
  • Referans33. Carlson M, Wilkerson J. Are differences in leg length predictive of lateral patello-femoral pain? Physiother Res Int. 2007; 12: 29-38.
  • Referans34. Kannus P, Niittymäki S. Which factors predict outcome in the nonoperative treatment of patellofemoral pain syndrome? A prospective follow-up study. Med Sci Sports Exerc. 1994; 26: 289-96.
There are 34 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original research article
Authors

Samet Sancar Kaya 0000-0003-4819-1128

Barış Nacır 0000-0002-9163-2569

Burcu Duyur Çakıt 0000-0003-1219-2356

Aynur Karagöz 0000-0003-3257-575X

Publication Date April 30, 2022
Submission Date May 5, 2021
Published in Issue Year 2022 Volume: 55 Issue: 1

Cite

AMA Kaya SS, Nacır B, Duyur Çakıt B, Karagöz A. INVESTIGATION OF MODIFIABLE RISK FACTORS IN PATIENTS WITH PATELLOFEMORAL PAIN SYNDROME. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. April 2022;55(1):13-17. doi:10.20492/aeahtd.933162