Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis

Lankhorst, N. E., van Middelkoop, M., Crossley, K. M., Bierma-Zeinstra, S. M. A., Oei, E. H. G., Vicenzino, B. and Collins, N. J. (2016) Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. British Journal of Sports Medicine, 50 881-886. doi:10.1136/bjsports-2015-094664


Author Lankhorst, N. E.
van Middelkoop, M.
Crossley, K. M.
Bierma-Zeinstra, S. M. A.
Oei, E. H. G.
Vicenzino, B.
Collins, N. J.
Title Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 1473-0480
0306-3674
Publication date 2016-07-01
Year available 2015
Sub-type Article (original research)
DOI 10.1136/bjsports-2015-094664
Open Access Status Not yet assessed
Volume 50
Start page 881
End page 886
Total pages 6
Place of publication London, United Kingdom
Publisher B M J Group
Collection year 2017
Language eng
Formatted abstract
Background: Patellofemoral pain (PFP) has traditionally been viewed as self-limiting, but recent studies show that a large proportion of patients report chronic knee pain at long-term follow-up. We identified those patients with an unfavourable recovery ('moderate improvement' to 'worse than ever' measured on a Likert scale) and examined whether there is an association between PFP and osteoarthritis (OA) at 5-8-year follow-up.

Methods: Long-term follow-up data were derived from 2 randomised controlled trials (n=179, n=131). Patientreported measures were obtained at baseline. Pain severity (100 mm visual analogue scale (VAS)), function (Anterior Knee Pain Scale (AKPS)) and self-reported recovery were measured 5-8 years later, along with knee radiographs. Multivariate backward stepwise linear regression analyses were used to evaluate the prognostic ability of baseline pain duration, pain VAS and AKPS on outcomes of pain VAS and AKPS at 5-8 years.

Results: 60 (19.3%) participants completed the questionnaires at 5-8-year follow-up (45 women, mean age at baseline 26 years) and 50 underwent knee radiographs. No differences were observed between responders and non-responders regarding baseline demographics, and 3-month and 12-month pain severity and recovery. 34 (57%) reported unfavourable recovery at 5-8 years. 48 out of 50 participants (98%) had no signs of radiographic knee OA. Multivariate models revealed that baseline PFP duration (>12 months; R2=0.22) and lower AKPS (R2=0.196) were significant predictors of poor prognosis at 5-8 years on measures of worst pain VAS and AKPS, respectively.

Summary and conclusion: More than half of participants with PFP reported an unfavourable recovery 5-8 years after recruitment, but did not have radiographic knee OA. Longer PFP duration and worse AKPS score at baseline predict poor PFP prognosis. Education of health practitioners and the general public will provide patients with more realistic expectations regarding prognosis.
Keyword Patellofemoral pain (PFP)
Chronic knee pain
Long-term follow-up
Osteoarthritis (OA)
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 3 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 31 Jul 2016, 00:19:00 EST by System User on behalf of Learning and Research Services (UQ Library)