Anterior Knee Pain

Diagnosis/Definition

Knee pain localized to the anterior portion of the knee, either retropatellar or peripatellar. Usually a gradual, non-traumatic onset aggravated with increased activity, running, squatting, stair climbing or prolonged sitting. Symptoms normally decrease with rest.

Initial Diagnosis and management

• History and physical examination
• Plain films not required
• NSAIDs
• Adults - 200 to 400 milligrams (mg) every four to six hours as needed for up to 2 weeks. Example: Ibuprofen
• Take tablet or capsule forms of these medicines with a full glass (8 ounces) of water.
• Do not lie down for about 15 to 30 minutes after taking the medicine. This helps to prevent irritation that may lead to trouble in swallowing.
• To lessen stomach upset, these medicines should be taken with food or an antacid.
• Avoidance of aggravating activities (profile for active duty soldiers)
• Strengthening exercises for quadriceps, stretching exercises for quads, hamstrings and calf muscle
• Ice PRN after activities
• Compression wrap is contraindicated
• Patient education (refer patient to PT for Retropatellar pain syndrome (RPPS) class)
• Please refer to the Clinical standard on knee pain

Ongoing Management and Objective

• Resolution or decreasing symptoms in three to four weeks
• If no resolution:
  • Trial of alternate NSAID
  • Trial of neoprene sleeve with patella opening
  • Obtain plain films with sunrise views
  • Do not order an MRI. Orthopedic clinic will order if patient meets pre-surgery criteria

Indication a profile is needed

• Any limitations that affect strength, range of movement, and efficiency of feet, legs, lower back and pelvic girdle.
• Slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects that may prevent moderate marching, climbing, timed walking, or prolonged effect.
• Defects or impairments that require significant restriction of use.