PainSci summary of 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 at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
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.
~ Paul Ingraham
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.
- “Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome,” an article in Journal of Bone & Joint Surgery, 2006.
- “Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function,” an article in Rev Bras Ortop, 2016.
- “Patellar maltracking is prevalent among patellofemoral pain subjects with patella alta: An upright, weightbearing MRI study,” an article in 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,” an article in Knee Surgery, Sports Traumatology, Arthroscopy, 2001.
- “Associates of physical function and pain in patients with patellofemoral pain syndrome,” an article in Archives of Physical Medicine & Rehabilitation, 2009.
- “The role of patellar alignment and tracking in vivo: the potential mechanism of patellofemoral pain syndrome,” an article in Physical Therapy in Sport, 2011.
These three articles on PainScience.com cite Smith 2009 as a source:
- PS Save Yourself from IT Band Syndrome! — All your treatment options for Iliotibial Band Syndrome reviewed in great detail, with clear explanations of recent scientific research supporting every key point
- PS Save Yourself from Patellofemoral Pain Syndrome! — Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
- PS Patellofemoral Tracking Syndrome — The beating heart of the conventional wisdom about patellofemoral pain is mostly nonsense
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:
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. Paige 2017 JAMA.
- Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-Analysis. Zhong 2017 Pain Physician.
- How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Soligard 2016 Br J Sports Med.
- Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. Chaibi 2016 Eur J Neurol.