Musculoskeletal Bibliography

OBJECTIVE: To evaluate the long-term results in patients with patello-femoral pain syndrome after expectant management.

DESIGN: Retrospective, case-control study.

SETTING: Community study in Sweden from 1981 to 1994.

PATIENTS: Forty-eight patients with patello-femoral pain syndrome were followed for a mean period of 11 years.

MAIN OUTCOME MEASURES: Patello-femoral joint evaluation scale (0-100 points) was used to evaluate the functional results. Arthroscopy for evaluation of cartilage damage according to Outerbridge, and clinical assessment of knee stability and, range of motion and Q-angle.

RESULTS: The functional results were excellent or good in 41 of 48 (85%) and poor in seven (15%). There was no correlation between the degree of cartilage damage and the level of knee function. Retropatellar cartilage damage was found in 28 patients during arthroscopy. There was no correlation between the degree of cartilage damage and the level of knee function. No patient has Outerbridge frade IV cartilage damage. The Q-angle was 2-23 degrees. There was no significant difference in Q-angle between patients with excellent/good results compared to those with poor.

CONCLUSION: Patients with patello-femoral pain syndrome should be managed nonsurgically as the natural course is benign in most cases. Surgical intervention should be used only if correction of anatomical malalignment is necessary and if the surgical methods have proven successful in well-controlled studies with a long follow-up period.