Chronic traumatic anterior knee pain

Chronic anterior knee pain following a direct injury to the front of the kn ee is common. The persistent symptoms can be troublesome. There is a paucit y of documentation regarding its definition, natural history and prognosis. We have reviewed 46 (92%) of a consecutive series of 50 patients with chro nic traumatic anterior knee pain, in which other significant acute knee pat hology was excluded. After a mean follow-up of 4 years and 8 months only 4% of patients were pain free, 68% had moderate or severe pain and 28% mild p ain. Twenty percent felt they were improving, 59% were static and 17% were deteriorating. The commonest clinical findings were patello-femoral crepitu s (96%), local tenderness (72%) and difficulty in squatting or kneeling (72 %). Few patients improve beyond 2 years and continued improvement is unlike ly. In patients referred for specialist advice this is a clinical syndrome characterised by persistent debilitating symptoms resistant to treatment. ( C) 2000 Elsevier Science Ltd. All rights reserved.