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Pressure algometry is a suitable tool to assess anterior knee pain in osteoarthritic patients

  • Pedro HinarejosEmail author
  • Nerea Goicoechea
  • Mauricio Gidi
  • Joan Leal-Blanquet
  • Raul Torres-Claramunt
  • Juan Sánchez-Soler
  • Joan Carles Monllau
Original Article • KNEE - ARTHRITIS
  • 67 Downloads

Abstract

Purpose

Anterior knee pain is a frequent symptom in the osteoarthritic knee. Its intensity has been classically evaluated by the visual analogic score (VAS). The main objective of the study was to assess whether pressure algometry (PA) can be used as a reliable tool to quantify anterior pain in the osteoarthritic knee.

Methods

A prospective study was designed, including 160 patients scheduled for unilateral total knee arthroplasty. Patellar pain and function were evaluated according to a specific patellofemoral pain questionnaire and the Knee Society Score. Patients were asked about their pain at rest, while walking and in the stairs with the VAS score. PA by an algometer was used in the anterior part of the patella to determine the pressure pain threshold (PPT): the minimal pressure when the patient feels a painful sensation.

Results

The mean values of PPT were 385.1 kPa in the knees going to be operated and 403.4 kPa in the contralateral knees (p < 0.05). The anterior knee pain in the patellar score averaged 6.9, and the total patellar score averaged 15.2. PPT values were correlated with the anterior pain in the patellar score (ρ = 0.31, p < 0.001) and also with the total patellar score (ρ = 0.33; p < 0.001).

Conclusions

PA demonstrated to be suitable to measure anterior knee pain in the osteoarthritic knee. PA can specifically assess the anterior knee pain better than other methods as VAS score. PA could be used as the main measurement when comparing different treatments for the anterior knee pain caused by osteoarthritis.

Keywords

Pressure algometry Pressure pain threshold Anterior knee pain Osteoarthritic knee 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

References

  1. 1.
    Stefanik JJ, Neogi T, Niu J, Roemer FW, Segal NA, Lewis CE, Nevitt M, Guermazi A, Felson DT (2014) The diagnostic performance of anterior knee pain and activity-related pain in identifying knees with structural damage in the patellofemoral joint: the Multicenter Osteoarthritis Study. J Rheumatol 41:1695–1702CrossRefGoogle Scholar
  2. 2.
    Breugem SJ, Haverkamp D (2014) Anterior knee pain after a total knee arthroplasty: what can cause this pain? World J Orthop 5:163–170CrossRefGoogle Scholar
  3. 3.
    Shervin D, Pratt K, Healey T, Nguyen S, Mihalko WM, El-Othmani MM, Saleh KJ (2015) Anterior knee pain following primary total knee arthroplasty. World J Orthop 6:795–803CrossRefGoogle Scholar
  4. 4.
    Metsna V, Vorobjov S, Lepik K, Märtson A (2014) Anterior knee pain following total knee replacement correlates with the OARSI score of the cartilage of the patella. Acta Orthop 85:427–432CrossRefGoogle Scholar
  5. 5.
    Torres-Claramunt R, Leal J, Hinarejos P, Pelfort X, Puig L (2013) Correlation study between KSS, WOMAC and SF-36 scores in patients undergoing total knee arthroplasty in a Spanish speaking population. J Arthroplasty 28:950–953CrossRefGoogle Scholar
  6. 6.
    Wylde V, Palmer S, Learmonth ID, Dieppe P (2011) Test-retest reliability of Quantitative Sensory Testing in knee osteoarthritis and healthy participants. Osteoarthr Cartil 19:655–658CrossRefGoogle Scholar
  7. 7.
    Feller JA, Bartlett RJ, Lang DM (1996) Patellar resurfacing versus retention in total knee arthroplasty. J Bone Jt Surg Br 78:226–228CrossRefGoogle Scholar
  8. 8.
    Ares O, Castellet E, Maculé F, León V, Montañez E, Freire A, Hinarejos P, Montserrat F, Amillo JR (2013) Translation and validation of ‘The Knee Society Clinical Rating System’ into Spanish. Knee Surg Sports Traumatol Arthrosc 21:2618–2624CrossRefGoogle Scholar
  9. 9.
    Altmış H, Oskay D, Elbasan B, Düzgün İ, Tuna Z (2018) Mobilization with movement and kinesio taping in knee arthritis-evaluation and outcomes. Int Orthop.  https://doi.org/10.1007/s00264-018-3938-3 Google Scholar
  10. 10.
    Bowman EN, Hallock JD, Throckmorton TW, Azar FM (2018) Hyaluronic acid injections for osteoarthritis of the knee: predictors of successful treatment. Int Orthop 42:733–740CrossRefGoogle Scholar
  11. 11.
    Maratea D, Fadda V, Trippoli S, Messori A (2014) Viscosupplementation in patients with knee osteoarthritis: temporal trend of benefits assessed by meta-regression. Eur J Orthop Surg Traumatol 24:829–830CrossRefGoogle Scholar
  12. 12.
    Ghinelli D, Parma A, Baldassarri M, Olivieri A, Mosca M, Pagliazzi G, Buda R (2016) High tibial osteotomy for the treatment of medial osteoarthritis of the knee with new iBalance system: 2 years of follow-up. Eur J Orthop Surg Traumatol 26:523–535CrossRefGoogle Scholar
  13. 13.
    Redish MH, Fennema P (2018) Good results with minimally invasive unicompartmental knee resurfacing after 10-year follow-up. Eur J Orthop Surg Traumatol 28:959–965CrossRefGoogle Scholar
  14. 14.
    Stefanik JJ, Duncan R, Felson DT, Peat G (2018) Diagnostic performance of clinical examination measures and pain presentation to identify patellofemoral joint osteoarthritis. Arthritis Care Res (Hoboken) 70:157–161CrossRefGoogle Scholar
  15. 15.
    Pelfort X, Torres-Claramunt R, Sánchez-Soler JF, Hinarejos P, Leal-Blanquet J, Valverde D, Monllau JC (2015) Pressure algometry is a useful tool to quantify pain in the medial part of the knee: an intra- and inter-reliability study in healthy subjects. Orthop Traumatol Surg Res 101:559–563CrossRefGoogle Scholar
  16. 16.
    vanWilgen P, van der Noord R, Zwerver J (2011) Feasibility and reliability of pain pressure threshold measurements in patellar tendinopathy. J Sci Med Sport 14:477–481CrossRefGoogle Scholar
  17. 17.
    Torres-Claramunt R, Pelfort X, Hinarejos P, Gil-González S, Leal J, Sánchez-Soler JF, Monllau JC (2018) Pressure algometry is an excellent tool to measure knee pain relief after a closing-wedge high tibial osteotomy. Orthop Traumatol Surg Res 104:193–196CrossRefGoogle Scholar
  18. 18.
    Rathleff MS, Petersen KK, Arendt-Nielsen L, Thorborg K, Graven-Nielsen T (2016) Impaired conditioned pain modulation in young female adults with long-standing patellofemoral pain: a single blinded cross-sectional study. Pain Med 17:980–988Google Scholar
  19. 19.
    van der Heijden RA, Rijndertse MM, Bierma-Zeinstra SM, van Middelkoop M (2018) Lower pressure pain thresholds in patellofemoral pain patients, especially in female patients: a cross-sectional case-control study. Pain Med 19:184–192CrossRefGoogle Scholar
  20. 20.
    Imamura M, Imamura ST, Kaziyama HH, Targino RA, Hsing WT, de Souza LP, Cutait MM, Fregni F, Camanho GL (2008) Impact of nervous system hyperalgesia on pain, disability, and quality of life in patients with knee osteoarthritis: a controlled analysis. Arthritis Rheum 59:1424–1431CrossRefGoogle Scholar
  21. 21.
    Pelfort X, Güerri RC, Sanchez JF, Dürsteler C, Valverde D, Hinarejos P, Leal J, Torres R, Puig L (2014) Bone microindentation and pressure algometry applied to revision total knee replacement and tibial end-of-stem pain. Preliminary results in a group of twenty patients. Rev Esp Cir Ortop Traumatol 58:206–211Google Scholar
  22. 22.
    Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Simonsen OH, Graven-Nielsen T (2010) Sensitization in patients with painful knee osteoarthritis. Pain 149:573–581CrossRefGoogle Scholar
  23. 23.
    Mutlu EK, Ozdincler AR (2015) Reliability and responsiveness of algometry for measuring pressure pain threshold in patients with knee osteoarthritis. J Phys Ther Sci 27:1961–1965CrossRefGoogle Scholar
  24. 24.
    Skou ST, Simonsen O, Rasmussen S (2015) Examination of muscle strength and pressure pain thresholds in knee osteoarthritis: test-retest reliability and agreement. J Geriatr Phys Ther 38:141–147CrossRefGoogle Scholar
  25. 25.
    Noehren B, Shuping L, Jones A, Akers DA, Bush HM, Sluka KA (2016) Somatosensory and biomechanical abnormalities in females with patellofemoral pain. Clin J Pain 32:915–919CrossRefGoogle Scholar
  26. 26.
    Wessel J (1995) The reliability and validity of pain threshold measurements in osteoarthritis of the knee. Scand J Rheumatol 24:238–242CrossRefGoogle Scholar
  27. 27.
    Neogi T, Frey-Law L, Scholz J, Niu J, Arendt-Nielsen L, Woolf C, Nevitt M, Bradley L, Felson DT, Multicenter Osteoarthritis (MOST) Study (2015) Sensitivity and sensitisation in relation to pain severity in knee osteoarthritis: trait or state? Ann Rheum Dis 74:682–688CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery, Consorci Parc de Salut Mar, Hospital de la EsperanzaUniversitat Autonoma de BarcelonaBarcelonaSpain

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