The effect of anterior knee pain on clinical outcomes after anterior cruciate ligament reconstruction with hamstring tendon graft

Introduction: The aim of this study was to investigate the effect of anterior knee pain on the clinical outcome, functional status and balance of the patients who underwent anterior cruciate ligament reconstruction with hamstring tendon graft. Material and Methods: Ninety patients who underwent surgery with hamstring tendon graft for at least 6 months ago were included in the study. Patients were grouped according to the presence of anterior knee pain. Demographic characteristics, physical examination findings and clinical status of 47 patients with anterior knee pain and 43 patients without anterior knee pain were evaluated. Subjective fuctional results were determined by KOOS questionnaire and Lysholm scores. Activity level of the patients were assessed with Tegner activity scale. Single leg hop, triple hop and crossover hop tests were performed to determine the objective functional testing. Static balance is assesed with SportKat device.. The effect of anterior knee pain and patients outcome was assessed. Results: The incidence of anterior knee pain was 52.2%. Thigh atrophy and Lysholm scores were lower in the group with anterior knee pain. The hop tests were significantly lower in the patients with anterior knee pain. Pain, symptoms, daily living activities, sports and quality of life scales, which were the 5 sub-headings of the KOOS questionnaire, were all lower in the anterior knee pain group. There was no significant relationship between demographic data such as age, gender, body mass index(BMI) and anterior knee pain. Conclusion: Anterior knee pain in patients who underwent anterior cruciate ligament reconstruction with hamstring tendon graft is not uncommon. In our study, anterior knee pain was associated with worse clinical outcomes and lower functional activity. Further studies with larger patient groups are needed to investigate the functional impairment of anterior knee pain.