What are the characteristics of anterior knee pain?
This characteristic pain tends to be associated with:
- forced activities -- squatting, weight bearing activities, running.
- prolonged sitting – producing stiffness, pain, or both, relieved by straightening (extending) the knee.
- on getting up from sitting, the pain may be severe, then diminishes and even disappears as the individual keeps walking.
- the “theatre sign” in some - where the individual seeks to sit at the end of any row of chairs, to allow the relief afforded by knee extension and even standing up,
- problems with walking - where the person may exhibit weakness, giving way of the knee, and 'catching'.
- stair climbing producing pain when weight is applied on the leg, when going up or down stairs.
- snapping, popping, or crunching in the knee occurring with activity as simple as walking, that may be accompanied by pain, which may be so severe that the individual feels that the knee locks.
Investigating anterior knee pain
Diagnosis is primarily one of exclusion, used when the cause of this type of pain has not been properly identified. In adolescents, where the complaint is seen quite frequently, the surgeon will try to exclude biomechanical causes relating to the patella and its underlying groove, and particularly to irritation of the fat pad.
Arthroscopic Untethering of the Fat Pad of the Knee: Release or Resection of the Infrapatellar Plica (Ligamentum Mucosum) and Related Structures for Anterior Knee Pain. Smallman TV, Portner OT, Race A, Shekitka K and Mann K. Arthrosc Tech. 2018 May; 7(5): e575–e588..
Anterior knee pain in the young athlete: diagnosis and treatment. Kodali P, Islam A, Andrish J. Sports Med Arthrosc Rev. 2011 Mar;19(1):27-33. doi: 10.1097/JSA.0b013e3182045aa1.