Anterior knee pain in adolescents and young adults

The problem of anterior knee pain continues to challenge serious students of the knee. Precise measurement techniques for each component of the soft-tissue envelope about the patella remain unknown. The biomechanical contributions of the medialis, the lateral retinaculum, the vastus lateralis obliquus, the iliotibial band, and the quadriceps during strenuous activity have yet to be measured. It is difficult to design studies of knee pain because of the diverse skeletal configurations of patellofemoral joints, unknown degrees of soft-tissue laxity, variations in the alignment of the knee, and other factors. As a result, indications for surgery, and nonoperative treatment, as well as effectiveness of rehabilitation modalities, continue to be debated. Terms used to describe the anterior patellofemoral spectrum vary, making uniform classification difficult.