Quality of life in adolescents with chronic non-traumatic knee pain: An analysis of 323 adolescents with Patellofemoral Pain and Osgood-Schlatter Disease

Abstract

IntroductionWe aimed to describe Quality of life (QoL) among adolescents with Patellofemoral Pain (PFP) and Osgood-Schlatter Disease (OSD) according to the QoL subscale of The Knee injury and Osteoarthritis Outcome Score (KOOS) and the EuroQol 5-dimensions (EQ-5D) and to investigate the characteristics associated with QoL.MethodsThis individual participant analysis included data from three clinical trials on adolescents diagnosed with PFP or OSD. We relabeled individual data and constructed a single dataset.ResultsWe included 323 adolescents with PFP or OSD. Total score of KOOS-QoL was 51±18 and total index score for the EQ5D was 0.67±0.21. KOOS-QoL subscale showed that 59% reported being aware of their knee problems daily or constantly, 37% reported severe to extreme lack of confidence in their knees, 27% reported severe to extreme difficulty with their knees, and 20% reported severely or totally modifying their lifestyle to avoid potentially damaging activities to their knee. EQ-5D showed that 77% experienced problems with everyday activities, 47% reported mobility problems, 17% felt worried, sad, or unhappy, and 7% reported problems looking after themselves. Older participants (age 17-19) reported worse QoL than younger participants. None of the other characteristics were associated with QoL.ConclusionsA high proportion of adolescents with chronic non-traumatic knee pain experience low QoL. More than half were aware of their knee problems at least daily, one in three reported a severe lack of confidence in their knee, and one in six felt worried, sad, or unhappy. QoL was lowest among older adolescents.Highlights-One in every three adolescents with PFP or OSD reported a severe lack of confidence in their knee.-Many adolescents reported being sad or worried, and modified their usual activities due to their knee pain.-Clinicians may extend the scope and include pain management strategies to address psychological perspectives when managing adolescents diagnosed with PFP or OSD.-Modifiable targets such as adolescents understanding of pain may be a beneficial management strategy to consider in rehabilitation for PFP or OSD.

Gait biomechanics do not differ between adolescents with and without patellofemoral pain

“…Daily pain is reported by more than 30% of adolescents 2 years on from their initial PFP diagnosis 1 . Adolescents with PFP have lower self‐reported quality of life and greater levels of anxiety and depression than adolescents without PFP 3,4 . Despite the poor prognosis and high prevalence, PFP research has largely focused on adult cohorts.…”

How do we explain painful non‐traumatic knee conditions to adolescents? A multiple‐method study to develop credible explanations

“…Non‐traumatic knee pain negatively impacts adolescents' quality of life, sleep quality, sports participation, and social interactions (Djurtoft et al., 2023; Holden et al., 2021; Rathleff et al., 2019). Adolescents living with chronic pain may also experience pain‐related stigma from family members, and peers (Fegran et al., 2021; Wakefield et al., 2022).…”

The Immediate Biomechanical Effects of a Flat, Flexible School Shoe in Adolescents with Patellofemoral Pain

“…More than 55% of adolescents who experience PFP report persistent symptoms after 2 to 6 yr (3,4). Daily pain is common in more than 60% of adolescents with PFP, and one in five reports modifying their lifestyle as a result of their knee pain (5). Over a 2-yr period, more than 70% of adolescents with PFP are likely to cease or reduce participation in physical or recreational activity (3).…”