LIVRE JDG 2012_DEF

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The morbidity of anterior knee pain occurring
after ACL reconstruction may be moderate to
severe and if symptoms persists and resist to
medical care, the patient may not be able to
resume sports practice on time or with lower
performances. The origin of symptoms is
sometimes obvious, such as Cyclops syndrome
with an associated lack of extension (fig. 1). In
this case, the solution is arthroscopic arthrolysis,
which gives satisfactory results for the patient.
But most of the time, the pain is not clearly
identified and is frequently called “tendinitis”
without any evidence in terms of imaging!
Actually, this type of pain could be explained
by various pathologies, not always easy to
diagnose or to treat successfully, such as
cartilage edema, stiffness, neuroma, muscle
insufficiency, adhesive wounds, bone bruise,
graft harvesting sequels, tendinitis, complex
regional pain syndrome, or reflex sympathetic
dystrophy syndrome [1].
The aim of our study was to analyze how
physicians from all over the world diagnose
and treat these problems. We also wanted to
design a simple general algorithm to facilitate
our approach to this difficult issue.
Materialand methods
A survey was designed and emails were sent to
a mailing list delivered by the MCO Congress.
Orthopedic surgeons, sports medicine
physicians, and rehabilitation physicians were
the target of our survey. The survey was built
on a free web access service delivered by
in two possible languages
(French or English). A simple questionnaire
was sent to all participants via a link on an
E-card at
php?code=b7d520a. Answers were collected
and processed on excel spreadsheets.
Anterior Knee Pain 3 Months
after acl Reconstruction:
an International Survey of
Practice
J. Barth, J.C. Panisset, F. Mauris, N. Bonin,
B. Sonnery-Cottet, D. Dejour and the Alrm Team
FIg. 1: Anterior knee pain related to a Cyclops
syndrome hanging at the roof of the notch. Note
that the patient had a very slight lack of extension.