Joint position sense in individuals with anterior knee pain.
Carlyn Rhode, Quinette A Louw, Dominique C Leibbrandt and 1 others
PMID 33824918WHAT IT FOUND
Knees with anterior knee pain were no more likely to have impaired joint position sense than pain-free knees in the same people.
Both groups averaged errors under five degrees, so routine proprioception testing may not distinguish these patients.
Key findings
01There was no significant difference in the proportion of impaired joint position sense between painful and pain-free knees during either single leg squat or active knee extension.
02The median absolute error for both painful and pain-free knees was less than five degrees, which the authors defined as normal proprioception.
03A small subgroup of knees with anterior knee pain did present with impaired joint position sense, but this was not statistically different from the pain-free knees in the same participants.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (25 participants), which limits the ability to detect smaller differences or to generalise findings to the wider population. The study compared painful knees to pain-free knees within the same participants, rather than to a separate healthy control group, which makes it difficult to know if both groups had altered proprioception compared to true norms. The threshold for 'impaired' proprioception (five degrees) was derived from healthy populations and has not been validated for people with anterior knee pain. The group of pain-free knees was much smaller (13 knees) than the group of painful knees (37 knees), creating an imbalance that complicates comparison. Only joint position sense was tested; other aspects of proprioception like motion sense were not assessed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that proprioception is normal in all patients with anterior knee pain. The study used a specific five-degree cutoff for impairment, and while the median errors were low, a subgroup of patients did show impairment. The lack of statistical significance may also be due to the small sample size rather than a true absence of any relationship.