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@article{Stephen:2016:10.1177/0363546516629432,
author = {Stephen, JM and Urquhart, DWJ and van, Arkel RJ and Ball, S and Jaggard, MKJ and Lee, JC and Church, JS},
doi = {10.1177/0363546516629432},
journal = {American Journal of Sports Medicine},
pages = {1195--1202},
title = {The use of sonographically guided botulinum toxin type A (Dysport) injections into the tensor fasciae latae for the treatment of lateral patellofemoral overload syndrome},
url = {http://dx.doi.org/10.1177/0363546516629432},
volume = {44},
year = {2016}
}

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TY  - JOUR
AB  - Background: Pain in the anterior and lateral parts of the knee during exercise is a common clinical problem for which current management strategies are often unsuccessful.Purpose: To investigate the effect of an ultrasound-guided botulinum toxin (BT) injection into the tensor fasciae latae (TFL), followed by physical therapy, in patients classified with lateral patellofemoral overload syndrome (LPOS) who failed to respond to conventional treatment.Study Design: Case series; Level of evidence, 4.Methods: A total of 45 patients (mean ± SD age, 32.4 ± 8.6 years) who met the inclusion criteria of (1) activity-related anterolateral knee symptoms, (2) symptoms lasting longer than 3 months, (3) a pathological abnormality confirmed by magnetic resonance imaging, and (4) previous failed physical therapy received an ultrasound-guided injection of BT into the TFL followed by physical therapy. Patient-reported outcomes were collected at 5 intervals: before the injection; at 1, 4, and 12 weeks after the injection; and at a mean 5 years after the injection. In 42 patients, relative iliotibial band (ITB) length changes were assessed using the modified Ober test at the first 4 time points. A computational model was run to simulate the effect of TFL weakening on gluteus medius (GMed) activity. Statistical analysis was undertaken using 1-way analysis of variance and paired t tests with Bonferroni post hoc correction.Results: There was a significant improvement in Anterior Knee Pain Scale scores from before the injection (61 ± 15) to 1 (67 ± 15), 4 (70 ± 16), and 12 weeks (76 ± 16) after the injection and in 87% of patients (39/45 patients available for follow-up) at approximately 5 years (from 62.9 ± 15.4 to 87.0 ± 12.5) after the injection (all P < .010). A significant effect on the modified Ober test was identified as a result of the intervention, with an increase in leg drop found at 1 (3° ± 5°), 4 (4° &
AU  - Stephen,JM
AU  - Urquhart,DWJ
AU  - van,Arkel RJ
AU  - Ball,S
AU  - Jaggard,MKJ
AU  - Lee,JC
AU  - Church,JS
DO  - 10.1177/0363546516629432
EP  - 1202
PY  - 2016///
SN  - 1552-3365
SP  - 1195
TI  - The use of sonographically guided botulinum toxin type A (Dysport) injections into the tensor fasciae latae for the treatment of lateral patellofemoral overload syndrome
T2  - American Journal of Sports Medicine
UR  - http://dx.doi.org/10.1177/0363546516629432
UR  - http://hdl.handle.net/10044/1/32394
VL  - 44
ER  -

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