By Vicente Sanchis-Alfonso

Clinically orientated and richly illustrated, this booklet offers whole information at the surgical and non-surgical administration of the anterior knee ache syndrome and is geared toward orthopedic surgeons, activities drugs practitioners, knee experts and actual therapists.

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6 Voluntary activity pattern measures in an indirect way the number of motor units, very useful when there is suspicion of muscle atrophy or hypertrophy. Electromyography data were collected with the Esaote Reporter® (Florence, Italy) electromyography system of 4 channels, with a program specifically designed for this study, with 2 channels fitted out, 5 seconds of sweep screen, filters of 100 Hz and 1 kHz, and 10 mV of amplitude. After skin preparation, which included shaving and cleaning with isopropyl alcohol, surface electrodes were placed on the muscle belly and tendinous attachment of both VMO and VL.

Many physicians believe that anterior knee pain is a sign of psychological problems. 44 What cannot be questioned is that anybody at whatever age can somatize or try to attract other people’s attention through some disease. In spite of this, one should be very cautious when it comes to suggesting to parents that their child’s problem is wholly psychological. Nonetheless, it has to be recognized that these types of patients present with a very particular psychological profile (see Chapter 6). Furthermore, there are patients with objective somatic problems who disproportionately exaggerate their pain because of some associate psychological component or secondary emotional or financial gains.

A possible explanation for this wide range of surgical indications could be that some orthopedic surgeons consider the lateral release as a minor risk-free surgical procedure. ” Surprisingly, in a survey of the IPSG23 on isolated lateral retinacular release, published in 2004 in Arthroscopy, most respondents (89%) indicated that this surgical procedure is a legitimate treatment, but only on rare occasions (1% to 2% of surgeries performed, less than 5 lateral releases a year). Furthermore, strong consensus (78%) existed that objective evidence should show lateral retinacular tension if a lateral release is to be performed.

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Anterior knee pain and patellar instability by Vicente Sanchis-Alfonso
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