AKP

AKP or  anterior knee pain has multiple possible causes.

What is anterior knee pain?

Several different problems may be experienced by patients as a diffuse pain in the front of the knee.

The term 'anterior knee pain' is not a diagnosis, but simply a description of what the patient is experiencing.

• Quote from peer-reviewed paper:

  "....The causes of AKP can be traced not only to structures within and around the knee, but also to factors outside the knee, such as limb malalignment, weakness of specific hip muscle groups, and core and ligamentous laxity...."

  Citation: D'Ambrosi R, Meena A, Raj A, Ursino N, Hewett TE. Anterior Knee Pain: State of the Art. Sports Med Open. 2022 Jul 30;8(1):98. doi: 10.1186/s40798-022-00488-x. PMID: 35907139; PMCID: PMC9339054.

• Quote from peer-reviewed paper:

  "....AKP warrants a pointed evaluation of history and thorough clinical examination, complemented with relevant radiological investigations to identify its origin in the knee and its cause...."

  Citation: D'Ambrosi R, Meena A, Raj A, Ursino N, Hewett TE. Anterior Knee Pain: State of the Art. Sports Med Open. 2022 Jul 30;8(1):98. doi: 10.1186/s40798-022-00488-x. PMID: 35907139; PMCID: PMC9339054.

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How does one investigate anterior knee pain?

Gender and sporting activities should be noted, together with the history of any injuries,especially patellar subluxations or dislocations.

It is important to note what brings on the pain - for example going up or down stairs, sitting still for a long time, jumping, landing. The patient should be asked about episodes of sudden 'catching' in the joint or 'giving way'.

The following need to be checked -

• at some distance from the knee - core strength, strength of specific hip muscles, limb and patellar alignment (squinting patella, q-angle)
• factors specifically related to the patellofemoral joint - local pain, swelling, instability
• examination for a medial plica (eg stutter test), and any suprapatellar plica
• the patellar tendon and tibial tubercle

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Imaging for anterior knee pain

Imaging is necessary to quantify alignment issues that may be contributing to the AKP.

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