Biological Causes of Anterior Knee Pain

We review the pathophysiology of anterior knee pain in the young patient. Emphasis is placed on newer findings. We have developed what we call the “Neural Model” as an explanation for the genesis of anterior knee pain. We have demonstrated a neuroanatomical basis for PFPS in the young patient and the clinical observation that the lateral retinaculum may have a key role in the origin of this pain. According to our studies we hypothesize that periodic short episodes of ischemia in the lateral retinaculum could be implicated in the pathogenesis of anterior knee pain, at least in a subgroup of anterior knee pain patients, by triggering neural proliferation of nociceptive axons (substance P posi…