The reliability and validity of assessing medio-lateral patellar position: a systematic review
Three articles on PainSci cite Smith 2009: 1. The Complete Guide to IT Band Syndrome 2. The Complete Guide to Patellofemoral Pain Syndrome 3. Patellofemoral Tracking Syndrome
PainSci commentary on Smith 2009: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Considering kneecap alignment is a reflex for most manual therapists — a staple of knee pain diagnosis. But is assessment of patellar alignment actually reliable? Probably not. This paper reviews nine reliability studies of 306 knees. (The authors note that this is not much evidence, and more is needed.) What evidence there is showed that assessment of patellar position was “variable” from one therapist to the next — in other words, the same patient is likely to get different diagnoses from different professionals. Patients and professionals should reconsider therapy based on assessments of patellar alignment.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Medio-lateral patellar position is regarded as a sign of patellofemoral pain syndrome and patellar instability. Its assessment is important in accurately performing patellofemoral therapeutic taping techniques. The purpose of this paper is to systematically review the literature to determine the reliability and validity of evaluating medio-lateral patellar position. An electronic database search was performed accessing AMED, British Nursing Index, CINAHL, the Cochrane database, EMBASE, Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Zetoc to July 2008. Conference proceedings and grey literature were also scrutinised for future publications. All human subject, clinical trials, assessing the inter- or intra-tester reliability, or the criterion validity, were included. A CASP tool was employed to evaluate methodological quality. Nine papers including 237 patients (306 knees) were reviewed. The findings of this review suggest that the intra-tester reliability of assessing medio-lateral patellar position is good, but that inter-tester reliability is variable. The criterion validity of this test is at worse moderate. These are based on a limited evidence-base. Further study is recommended to compare the McConnell (1986) and Herrington (2002) methods of assessing medio-lateral patellar position in patients with well-defined patellofemoral disorders.
related content
- “Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome,” MacIntyre et al, Journal of Bone & Joint Surgery, 2006.
- “Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function,” Almeida et al, Rev Bras Ortop, 2016.
- “Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: An upright, weightbearing MRI study,” Pal et al, Journal of Orthopaedic Research, 2013.
- “Patello-femoral tracking in the weight-bearing knee: a study of asymptomatic volunteers utilising dynamic magnetic resonance imaging: a preliminary report,” Tennant et al, Knee Surgery, Sports Traumatology, Arthroscopy, 2001.
- “Associates of physical function and pain in patients with patellofemoral pain syndrome,” Piva et al, Archives of Physical Medicine & Rehabilitation, 2009.
- “The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome,” Song et al, Physical Therapy in Sport, 2011.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.