Advanced Non-Operative Interventions for Anterior Knee Pain

Area of Science:

• Orthopedics
• Regenerative Medicine
• Sports Medicine

Background:

• Anterior knee pain encompasses various conditions like osteoarthritis, patellofemoral pain syndrome, and tendinopathies.
• Non-operative interventions are increasingly explored for managing these conditions.

Purpose of the Study:

• To review evidence for advanced non-operative treatments for adult anterior knee pain.
• To evaluate interventions including ESWT, prolotherapy, PRP, cell-based therapies, and needle interventions.

Main Methods:

• Systematic review of current literature on non-operative anterior knee pain treatments.
• Case-based analysis of interventions for specific etiologies.
• Assessment of the strength of evidence for each modality.

Main Results:

• Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) have the strongest evidence for tibiofemoral osteoarthritis and patellar tendinopathy.
• Botulinum neurotoxin type A shows promise for patellofemoral pain syndrome.
• Evidence for other injectates, cell-based therapies, and needle tenotomy is limited, necessitating further research.

Conclusions:

• ESWT and PRP are well-supported options for specific anterior knee pain conditions.
• Further research and standardized protocols are crucial for optimizing treatments like prolotherapy, cell-based therapies, and needle interventions.
• Personalized selection of interventions based on evidence and patient activity is key to improving outcomes.