A conservative approach to anterior knee pain

Eight-five patients with sole anterior knee pain were treated with a physical therapy program and a nonsteroidal antiinflammatory medication. Physical therapy consisted of regimented stretching exercises, quadriceps electrical stimulation, isometric quadriceps sets, ice application after treatment, progressive straight-leg raising, and short-arc quadriceps sets. After a disciplined progression of physical therapy and daily activity, patients were questioned about the amount of their knee dysfunction secondary to pain and their level of activity. Eighty-seven percent of these patients described their knee symptoms as improved immediately after a physical therapy program. Sixty-eight percent believed their symptoms were improved when reviewed at follow-up interview (mean duration, 16.0 months). All follow-up information was obtained via phone interview using a checksheet question form to eliminate subject bias. At the time of interview, 57% believed that their level of activity substantially increased from their level at initial evaluation. These data dictate that a trial of physical therapy and nonsteroidal antiinflammatory medication should be used as initial treatment for anterior knee pain.