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Patellofemoral Pain in Adolescence and Adulthood: Same Same, but Different?

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Abstract

The mainstay of patellofemoral pain (PFP) treatment is exercise therapy, often in combination with adjunct treatments such as patient education, orthoses, patella taping and stretching, making the intervention multimodal in nature. The vast majority of randomised controlled trials among patients with PFP have investigated the effect of treatment among adults (>18 years of age). So, while systematic reviews and meta-analyses provide evidence-based recommendations for treating PFP, these recommendations are largely based upon the trials in adults. In the present article, we have summarised the findings on the efficacy of multimodal treatment (predominantly exercise) from the three largest trials concerning patients with PFP, focusing on the long-term success-rate 1 year after receiving multimodal treatment, and with a particular focus on the success rate across the different age groups, including both adolescents, young adults and adults. The results of this paper show that there appears to be a difference in the success rate between adolescents and adults, despite providing similar exercise treatment and having similar exercise compliance. While PFP may present in a similar fashion in adolescence and adults, it may not be the same underlying condition or stage, and different treatments may be required. Collectively, this highlights the importance of increasing our understanding of the underlying pathology, pain mechanisms and why treatment may—or may not—work in adolescents and adults with PFP.

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Acknowledgments

The Danish Research Council is acknowledged for providing funding for this research. Grant DFF-4004-00247B.

None of the authors have any potential conflict of interest regarding the content of this article.

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Authors and Affiliations

  1. Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7A, 9220, Aalborg, Denmark

    M. S. Rathleff & T. Graven-Nielsen

  2. Department of Occupational and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark

    M. S. Rathleff

  3. Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, St Lucia, Australia

    B. Vicenzino

  4. Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands

    M. Middelkoop

  5. Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

    R. van Linschoten

  6. Sports Orthopedic Research Center-Copenhagen, Arthroscopic Centre Amager, Copenhagen University Hospital, Amager-Hvidovre, Denmark

    P. Hölmich & K. Thorborg

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  1. M. S. Rathleff
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  2. B. Vicenzino
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  3. M. Middelkoop
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  4. T. Graven-Nielsen
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  5. R. van Linschoten
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  6. P. Hölmich
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Correspondence to M. S. Rathleff.

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Rathleff, M.S., Vicenzino, B., Middelkoop, M. et al. Patellofemoral Pain in Adolescence and Adulthood: Same Same, but Different?. Sports Med 45, 1489–1495 (2015). https://doi.org/10.1007/s40279-015-0364-1

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