Association between Patellofemoral Conditions and the Incidence of ACL Injury: Could Patellofemoral Conditions be a Risk Factor for ACL Injury? A 10-year Population-Based Study.
Luke Bunch, Anthony T Drazick, Ghislain Aminake and 4 others
Patellofemoral patients in this cohort had a 2.5% ACL injury rate, well above the general population rate of 68 per 100,000 per year.
Most injuries hit the same knee, with a median of 10.5 months from diagnosis. No demographic factor independently predicted the risk.
Key findings
1Patients with a patellofemoral diagnosis had a 2.5% ACL injury rate (246 per 100,000 person-years), higher than the general population rate of about 68 per 100,000 per year cited in the literature.
2Of injuries where the side could be determined, 83.3% (n = 100) were on the same side as the original patellofemoral diagnosis, and the median time from PFC diagnosis to ACL injury was 10.5 months.
3Multivariable logistic regression adjusting for age, sex, and BMI found no statistically significant independent predictors of ACL injury; all confidence intervals for the odds ratios crossed 1.
Still to come
How it was doneWhat they foundWhat it means for PTs
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What it does not show
All patients came from one health system, so the findings may not hold in other settings. Injuries treated outside that system would not appear in the data. Because the records were pulled backward, patients who left the system, moved, or switched providers could have been lost, and the authors acknowledge they could not track them. PFC is a broad label covering pain, instability, subluxation, dislocation, and chondromalacia, so the group is heterogeneous even after manual chart review. Sports participation, activity level, whether patients actually did their rehab, and other medical conditions were not in the dataset, so the analysis could not account for them. No sample size was calculated before the study, and no sensitivity analyses were run. There was no control group within the study; the comparison is to a general population rate from the literature.
Declared interests
No conflicts of interest were reported.
The easy way to misread this
Do not read this as proof that patellofemoral pain causes ACL tears or that treating the pain will prevent the tear. The study is a single-cohort record review with no control group, no intervention was tested, and the authors state the findings show an association, not a causal mechanism.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →