Sports and Exercise Medicine, School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University London, Mile End Hospital, Bancroft Road, London, E1 4DG, UK.
Sports and Exercise Medicine, School of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University London, Mile End Hospital, Bancroft Road, London, E1 4DG, UK; School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3WA, UK.
Musculoskelet Sci Pract. 2022 Apr;58:102530. doi: 10.1016/j.msksp.2022.102530. Epub 2022 Feb 11.
Patellofemoral pain (PFP) is common and has a poor long-term prognosis. There is a lack of clarity about the clinical reasoning of recognised inter-disciplinary experts in the published literature.
To help identify best practice by exploring the clinical reasoning of a range of inter-disciplinary experts that regularly diagnose and treat PFP.
Qualitative study with semi-structured interviews.
Recruitment resulted in a convenience sample for semi-structured interview, which were recorded and transcribed verbatim. Data were analysed until theoretical saturation, as determined by multiple investigators.
Interviews with 19 clinical experts (15 men, 4 women; mean experience 18.6 years ± 8.6) from four broad professions yielded four themes. Firstly, the assessment and diagnosis process should include a thorough history and examination to rule in PFP. Secondly, information provision should aim to increase patients' understanding, aid in controlling symptoms, and facilitate behaviour change. Thirdly, active rehabilitation, which was a salient theme and included advocacy of combined hip and knee exercise that is adapted to the individual. Finally, treatment adjuncts, which can be used selectively to modify symptoms, may include running retraining, taping, or foot orthoses.
PFP should be diagnosed clinically, and tailored treatment programmes should be prescribed for people with PFP. Exercise was considered the most effective treatment and underlying psychological factors should be addressed to improve prognosis.
髌股疼痛（PFP）很常见，且长期预后较差。在已发表的文献中，对于公认的跨学科专家的临床推理，其内容并不清晰。
通过探索经常诊断和治疗 PFP 的一系列跨学科专家的临床推理，以帮助确定最佳实践。
具有半结构化访谈的定性研究。
招募产生了半结构化访谈的便利样本，对其进行了记录和逐字转录。数据分析一直持续到多个调查人员确定的理论饱和度。
对来自四个广泛专业的 19 名临床专家（15 名男性，4 名女性；平均经验 18.6 年±8.6 年）进行的访谈产生了四个主题。首先，评估和诊断过程应包括详细的病史和检查，以排除 PFP。其次，信息提供应旨在增加患者的理解，帮助控制症状，并促进行为改变。第三，积极的康复，这是一个突出的主题，包括提倡针对个人的联合髋关节和膝关节运动。最后，可选择性使用治疗辅助手段来减轻症状，包括跑步训练、贴扎或足矫形器。
应该通过临床诊断 PFP，并为 PFP 患者开具量身定制的治疗方案。运动被认为是最有效的治疗方法，应解决潜在的心理因素，以改善预后。
