Hinarejos Pedro, Goicoechea Nerea, Gidi Mauricio, Leal-Blanquet Joan, Torres-Claramunt Raul, Sánchez-Soler Juan, Monllau Joan Carles
Department of Orthopedic Surgery, Consorci Parc de Salut Mar, Hospital de la Esperanza, Universitat Autonoma de Barcelona, Sant Josep de la Muntanya, 12, 08024, Barcelona, Spain.
Eur J Orthop Surg Traumatol. 2019 Jul;29(5):1089-1093. doi: 10.1007/s00590-019-02391-w. Epub 2019 Feb 7.
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.
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.
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).
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.
膝关节前侧疼痛是骨关节炎膝关节的常见症状。其强度传统上通过视觉模拟评分法（VAS）进行评估。本研究的主要目的是评估压力测痛法（PA）是否可作为量化骨关节炎膝关节前侧疼痛的可靠工具。
设计了一项前瞻性研究，纳入160例计划进行单侧全膝关节置换术的患者。根据特定的髌股关节疼痛问卷和膝关节协会评分评估髌前疼痛和功能。使用VAS评分询问患者静息时、行走时和上下楼梯时的疼痛情况。使用压力计在髌骨前部进行PA以确定压力疼痛阈值（PPT）：患者感到疼痛的最小压力。
拟手术膝关节的PPT平均值为385.1 kPa，对侧膝关节为403.4 kPa（p < 0.05）。髌前疼痛评分平均为6.9，髌总评分平均为15.2。PPT值与髌前疼痛评分中的前侧疼痛相关（ρ = 0.31，p < 0.001），也与髌总评分相关（ρ = 0.33；p < 0.001）。
PA被证明适用于测量骨关节炎膝关节的前侧疼痛。与VAS评分等其他方法相比，PA能更具体地评估前侧膝关节疼痛。在比较针对骨关节炎引起的前侧膝关节疼痛的不同治疗方法时，PA可作为主要测量方法。
