National Physical Therapy Examination (NPTE) Practice Exam

What LE position observed in an adolescent female with anterior knee pain may be indicative of excessive hip?

1. Retroversion

2. Medial/IR

3. Anteversion

4. Lateral/ER

The correct answer is: Anteversion

In adolescents, anterior knee pain can often be influenced by hip position due to the interconnectedness of the kinetic chain. When considering the position of the lower extremity, "anteversion" refers to an increase in the forward rotation of the hip joint, which results in a more internally rotated (IR) femur position. This altered alignment can lead to biomechanical changes in the lower extremity, including excessive internal rotation of the femur and potentially causing compensatory movements at the knee joint. The internal rotation can increase the stress on the patellofemoral joint due to an abnormal tracking of the patella, contributing to anterior knee pain. Additionally, I would like to note that while other positions such as retroversion or lateral/external rotation may influence the biomechanics of the knee, they typically do not relate as directly to the common presentations of excessive hip internal rotation seen in cases of anterior knee pain. Medial or internal rotation of the lower extremity is indeed associated with increased risk of patellofemoral issues, but it is the anteversion that is most commonly linked to these patterns in adolescents. Thus, the recognition of anteversion in the context of hip alignment is crucial for understanding its implications on knee pain.