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IDIOPATHIC ANTERIOR KNEE PAIN: WHAT IS THE ELECTROPHYSIOLOGICAL EVIDENCE?



Abstract

Introduction: Poor proprioception and imbalance between quadriceps and hamstrings have been suggested as causes for anterior knee pain. The aim of our study was to compare the proprioception of patients with anterior knee pain to a normal population and to compare the activity of quadriceps and hamstrings using electromyography (EMG) in the 2 groups.

Methods: Patients and controls between the ages 11–25 yrs were recruited into the study. The proprioception (stability index) of the patients and controls was tested using the Biodex stability system. This computerised system tests the ability of a person to balance his/her own body on a platform that moves in various directions. Surface EMG was recorded from the quadriceps and hamstrings during this test. EMG was also recorded as the patients and controls stepped onto a 20cm step. EMG activity was normalised to levels elicited during maximal isometric contractions.

Results: 18 patients and 27 controls were recruited.

We found no significant difference between the groups in the EMG intensity of vastus lateralis relative to biceps femoris, or vastus medialis relative to vastus lateralis, during the balance test or during the step up task (Mann Whitney U test all p> 0.05). We did not find any difference in the proprioceptive abilities of the two groups

Conclusion: We found no significant difference between the groups in the intensity of muscle contraction of the hamstrings relative to the quadriceps, i.e. no evidence for an imbalance in the patients. However the temporal relation between the two needs further investigation.

Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.