Clin Orthop Surg.  2014 Dec;6(4):426-431. 10.4055/cios.2014.6.4.426.

Anterior Knee Pain in Patients with Cerebral Palsy

• Choi Y
• Lee SH
• Chung CY
• Park MS
• Lee KM
• Sung KH
• Won SH
• Lee IH
• Choi IH
• Cho TJ
• Yoo WJ
• Lee SY

• KMID: 1794731
• DOI: http://doi.org/10.4055/cios.2014.6.4.426

Abstract

BACKGROUND
The aim of this study was to identify the risk factors for anterior knee pain in patients with cerebral palsy.
METHODS
This prospective study investigated the risk factors for anterior knee pain in 127 ambulatory patients with spastic cerebral palsy in terms of walking pain, resting pain, and provocative pain. Demographic data analysis and physical examination for measuring the knee flexion contracture and unilateral and bilateral popliteal angles were performed. Patellar height was measured on radiographs, and patella alta was identified. The risk factors for anterior knee pain were analyzed using multivariate analysis with a generalized estimating equation.
RESULTS
Seventy-seven patients were found to have patella alta based on the radiographic measurements (60.6%). Overall, sixteen patients (12.6%) had either unilateral or bilateral anterior knee pain. Of these, 6 patients showed a visual analogue scale (VAS) < or = 3, 9 patients showed 3 < VAS < or = 7, and one patient showed a VAS > 7. Age was found to be a significant risk factor for walking pain and resting pain with odds ratios (ORs) of 1.08 (95% confidence interval [CI], 1.02 to 1.14) and 1.09 (95% CI, 1.03 to 1.15), respectively. In the multivariate analysis, knee flexion contracture was a significant protective factor with an OR of 0.92 (95% CI, 0.85 to 0.98).
CONCLUSIONS
Approximately 12.6% of ambulatory patients with spastic cerebral palsy were found to have anterior knee pain in our hospital-based cohort study. Age was found to be a significant risk factor for anterior knee pain while walking and resting.

Keyword

Patellofemoral pain syndrome; Cerebral palsy; Patella alta; Popliteal angle

MeSH Terms

Adolescent
Age Factors
Arthralgia/*etiology/physiopathology
Cerebral Palsy/*complications/physiopathology
Child
Female
Humans
*Knee Joint/physiopathology
Male
Prospective Studies
Range of Motion, Articular
Risk Factors
Walking
Young Adult

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