The role of botulinum toxin type A in the clinical management of refractory anterior knee pain

Barby Singer, B.I. Silbert, Peter Silbert, Kevin Singer

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    Abstract

    © 2015 by the authors; licensee MDPI, Basel, Switzerland. Anterior knee pain is a highly prevalent condition affecting largely young to middle aged adults. Symptoms can recur in more than two thirds of cases, often resulting in activity limitation and reduced participation in employment and recreational pursuits. Persistent anterior knee pain is difficult to treat and many individuals eventually consider a surgical intervention. Evidence for long term benefit of most conservative treatments or surgical approaches is currently lacking. Injection of Botulinum toxin type A to the distal region of vastus lateralis muscle causes a short term functional “denervation” which moderates the influence of vastus lateralis muscle on the knee extensor mechanism and increases the relative contribution of the vastus medialis muscle. Initial data suggest that, compared with other interventions for anterior knee pain, Botulinum toxin type A injection, in combination with an active exercise programme, can lead to sustained relief of symptoms, reduced health care utilisation and increased activity participation. The procedure is less invasive than surgical intervention, relatively easy to perform, and is time- and cost-effective. Further studies, including larger randomized placebo-controlled trials, are required to confirm the effectiveness of Botulinum toxin type A injection for anterior knee pain and to elaborate the possible mechanisms underpinning pain and symptom relief.
    Original languageEnglish
    Pages (from-to)3388-3404
    JournalToxins
    Volume7
    Issue number9
    DOIs
    Publication statusPublished - 2015

    Fingerprint

    Type A Botulinum Toxins
    Refractory materials
    Muscle
    Knee
    Quadriceps Muscle
    Pain
    Muscles
    Injections
    Health care
    Patient Acceptance of Health Care
    Denervation
    Switzerland
    Randomized Controlled Trials
    Placebos
    Costs
    Exercise
    Costs and Cost Analysis

    Cite this

    Singer, Barby ; Silbert, B.I. ; Silbert, Peter ; Singer, Kevin. / The role of botulinum toxin type A in the clinical management of refractory anterior knee pain. In: Toxins. 2015 ; Vol. 7, No. 9. pp. 3388-3404.
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    The role of botulinum toxin type A in the clinical management of refractory anterior knee pain. / Singer, Barby; Silbert, B.I.; Silbert, Peter; Singer, Kevin.

    In: Toxins, Vol. 7, No. 9, 2015, p. 3388-3404.

    Research output: Contribution to journalArticle

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    AB - © 2015 by the authors; licensee MDPI, Basel, Switzerland. Anterior knee pain is a highly prevalent condition affecting largely young to middle aged adults. Symptoms can recur in more than two thirds of cases, often resulting in activity limitation and reduced participation in employment and recreational pursuits. Persistent anterior knee pain is difficult to treat and many individuals eventually consider a surgical intervention. Evidence for long term benefit of most conservative treatments or surgical approaches is currently lacking. Injection of Botulinum toxin type A to the distal region of vastus lateralis muscle causes a short term functional “denervation” which moderates the influence of vastus lateralis muscle on the knee extensor mechanism and increases the relative contribution of the vastus medialis muscle. Initial data suggest that, compared with other interventions for anterior knee pain, Botulinum toxin type A injection, in combination with an active exercise programme, can lead to sustained relief of symptoms, reduced health care utilisation and increased activity participation. The procedure is less invasive than surgical intervention, relatively easy to perform, and is time- and cost-effective. Further studies, including larger randomized placebo-controlled trials, are required to confirm the effectiveness of Botulinum toxin type A injection for anterior knee pain and to elaborate the possible mechanisms underpinning pain and symptom relief.

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