Search Results (224)

Patellofemoral pain (PFP) in athletes is associated with lower-limb kinetic-chain constraints, yet rehabilitation strategies targeting both hip and ankle mobility remain insufficiently examined. This assessor-blinded randomized controlled trial investigated the effects of a 6-week hip and ankle mobility-based rehabilitation program in male collegiate athletes with PFP. Forty-eight participants were assigned using computer-generated 1:1 randomization to an intervention group (n = 24) or a control group (n = 24). The intervention group completed supervised hip and ankle mobility rehabilitation three times weekly, whereas the control group maintained regular sport-specific training only. Co-primary outcomes were pain intensity assessed using a 10-cm visual analog scale (VAS) and knee-related function assessed using the Kujala score. Secondary outcomes included hip rotation range of motion, weight-bearing ankle dorsiflexion, vastus medialis–vastus lateralis (VM–VL) onset timing, Y-Balance Test (YBT) composite score, and countermovement jump (CMJ) height. Significant group × time interactions favored the intervention group for VAS (p < 0.0001; partial η² = 0.436; change difference: −1.54 cm; 95% CI: −2.06 to −1.02) and Kujala score (p < 0.0001; partial η² = 0.285; change difference: 8.00 points; 95% CI: 4.24 to 11.76). Significant interactions were also observed for hip internal and external rotation range of motion, weight-bearing ankle dorsiflexion, VM–VL onset timing during a controlled squat task, and YBT composite score (all p ≤ 0.0405; partial η² = 0.088–0.374). No significant group × time interaction was observed for CMJ height (p = 0.0511; partial η² = 0.080). These findings suggest that, compared with regular sport-specific training alone, adding a supervised hip and ankle mobility-based rehabilitation program may improve pain, knee-related function, targeted mobility outcomes, VM–VL onset timing during a controlled squat task, and dynamic balance in the short term. However, because the control group did not receive an active or attention-matched intervention, these findings should be interpreted as the added effect of the supervised rehabilitation program rather than as definitive evidence of mobility-specific treatment effects. In addition, because patellar tracking, knee kinematics, joint kinetics, and patellofemoral joint loading were not directly measured, the findings should be interpreted as clinical and functional outcome changes rather than direct evidence of a confirmed biomechanical mechanism. Trial registration: NCT07542236. Full article

Background/Objectives: Patellar chondromalacia (PC) is a clinical condition characterized by early cartilage degeneration in the patellofemoral joint. This study aimed to investigate the relationship between the lateral-to-medial femoral condyle length ratio (LFCL/MFCL) measured on standard anteroposterior (AP) knee radiographs and the presence of PC. Methods: A retrospective analysis was conducted on patients who presented with anterior knee pain between 2020 and 2024. PC was diagnosed using magnetic resonance imaging (MRI). The LFCL/MFCL ratio was measured on plain radiographs. Additional morphological condylar parameters were evaluated on MRI. Symptom severity was assessed using the Kujala score. Statistical analyses included t-tests, correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: A total of 100 patients (50 with PC, 50 controls) were included. The LFCL/MFCL ratio was significantly higher in the PC group compared to controls (1.24 ± 0.19 vs. 1.08 ± 0.15, p = 0.002). A negative correlation was found between the LFCL/MFCL ratio and Kujala score (r = −0.322, p = 0.029). Other MRI-based parameters did not show statistically significant differences. In logistic regression, the LFCL/MFCL ratio was identified as an independent predictor of PC (p = 0.01). ROC analysis yielded an AUC of 0.743 (95% CI: 0.643–0.842). Conclusions: The LFCL/MFCL ratio, which can be easily measured on plain radiographs, may serve as a simple, cost-effective, and reproducible parameter to aid in the diagnosis of patellar chondromalacia. Further prospective studies with larger sample sizes are needed to validate this finding. Full article

Background: Platelet-rich plasma (PRP) is utilised in the treatment of patellofemoral chondropathy, although clinical responses remain variable. This retrospective exploratory study assessed whether baseline quantitative T2* mapping of femoral cartilage was associated with clinical improvement following PRP administration. Methods: In this retrospective observational study conducted within routine clinical practice, patients with patellofemoral chondropathy received three ultrasound-guided intra-articular PRP injections administered weekly according to an institutional protocol. Baseline and 9-month T2*-mapping MRI scans and clinical questionnaires were collected as part of standard follow-up. The main imaging variable was the worst-region femoral trochlear T2* value, evaluated as a candidate prognostic biomarker. Clinical outcomes included the Visual Analogue Scale (VAS, 0–10) and Kujala (0–100) scores, with responders defined by minimum clinically important difference (MCID) thresholds (ΔVAS ≥ 1.5; ΔKujala ≥ 8). Results: Thirty-two knees from 22 patients completed follow-up, including 10 bilateral cases (19 right knees, 13 left knees). Both VAS and Kujala scores improved significantly at 9 months (p < 0.001 for both). Baseline femoral trochlear worst-region T2* values were inversely correlated with pain and functional improvement (ΔVAS: rho = −0.51, p = 0.003; ΔKujala: rho = −0.36, p = 0.042). Baseline patellar T2* values were not associated with clinical change (ΔVAS: rho = −0.18, p = 0.32; ΔKujala: rho = −0.12, p = 0.51). Sensitivity analyses using baseline mean femoral T2* values did not show significant associations with ΔVAS or ΔKujala. Interobserver reproducibility for the worst-region T2* metric was limited, particularly for the femoral compartment (femur ICC 0.37; patella ICC 0.47), which limits immediate clinical applicability. Mean regional longitudinal ΔT2* changes did not exceed the 14% QIBA MDC95 threshold. Conclusions: In this small retrospective cohort, baseline femoral trochlear worst-region T2* values were associated with clinical improvement after PRP. These preliminary hypothesis-generating findings should be interpreted with caution and require validation in larger controlled cohorts with standardised and reproducible segmentation workflows. Full article

Background: Proximal lower-extremity muscle strengthening is an important conservative intervention for patellofemoral pain syndrome (PFPS), as these muscle groups play critical roles in femoral stabilization and knee valgus control. However, evidence remains limited regarding the effectiveness of muscle strengthening in improving lower-extremity axial alignment through modulation of femoral neck anteversion, femoral internal rotation, and tibial external rotation. Therefore, the present study aimed to determine whether a strengthening protocol targeting the quadriceps and hip external rotator and hip abductor muscles could improve knee alignment and reduce bone torsion in young adults with patellofemoral pain syndrome. Methods: This prospective interventional cohort study implemented a muscle strengthening protocol in ten university students with PFPS. Outcomes included femoral neck anteversion angle (FNA), tibial tubercle–trochlear groove distance (TT–TG), tibial external torsion angle (TET), and the knee Q-angle, assessed via 3D reconstruction of computed tomography (3D-CT) images. Pre- and post-intervention data were analyzed using the Shapiro-Wilk test for normality and repeated-measures ANOVA (p < 0.05; 95% confidence interval). Results: Muscle strengthening improved lower-limb axial alignment, with reductions observed across all measures post-intervention. Mean changes were 0.68 ± 1.26° for FNA (p = 0.0626); 1.51 ± 0.97 mm for TT–TG (p = 0.0001); 1.38 ± 3.36° for TET (p = 0.2231); and 1.14 ± 1.52° for the Q-angle. Statistically significant improvements were observed for TT–TG and the Q-angle. Conclusions: Proximal muscle strengthening improved knee valgus and axial lower-limb alignment, as evidenced by significant reductions in Q angle and TT–TG distance. Reductions in femoral neck anteversion (FNA) and tibial external torsion angle (TET) were observed. However, these differences were not statistically significant. These findings support muscle strengthening as a noninvasive strategy for improving lower-limb alignment in individuals with patellofemoral pain syndrome. Full article

Background: Patellar motion trajectory (PMT) is a key kinematic parameter for evaluating patellofemoral joint (PFJ) stability, but traditional static imaging indices are unable to capture the dynamic six-degrees-of-freedom (6-DOF) characteristics of patellar motion throughout the entire knee flexion–extension cycle. Four-dimensional computed tomography (4D-CT) facilitates in vivo dynamic imaging of the PFJ, while the systematic classification of PMT in asymptomatic populations has remained underexplored. Methods: A retrospective cross-sectional study was performed on 64 asymptomatic and functionally normal knees that underwent 4D-CT dynamic scanning from March 2021 to December 2025. Patellar 6-DOF kinematic data during 0° to 90° of knee flexion–extension were extracted through manifold optimization, automatic segmentation, and spatial registration. Following standardization of the motion cycle, unsupervised K-means clustering was employed to classify PMT phenotypes, with nonparametric tests used to analyze intergroup kinematic differences and evaluate clustering quality. Results: Three distinct PMT types were identified based on clustering validity indices, including a silhouette score of 0.381, a Davies-Bouldin index of 0.916, and a Calinski–Harabasz index of 44.06: Type 1 (7.81%, 35.11 ± 6.56 mm), Type 2 (56.25%, 15.67 ± 6.59 mm), and Type 3 (35.94%, 2.82 ± 2.41 mm). Lateral translation (Tx) served as the dominant determinant for PMT typing (p < 0.001), whereas non-lateral DOF parameters exhibited no consistent intergroup differences. Postural DOFs exhibited coupled fluctuations with Tx but had no independent stratification effect. Traditional static imaging parameters demonstrated no consistent correlation with these dynamic subtypes. Conclusions: Functionally asymptomatic knees exhibited three in vivo patellar 6-DOF motion trajectory phenotypes dominated by lateral translation amplitude. This 4D-CT-based typing framework provides a dynamic kinematic baseline for PFJ stability evaluation and lays a foundation for individualized optimization of ligament reconstruction and pathophysiological research of patellofemoral disorders. Full article

This study evaluated the test–retest reliability, standard error of measurement (SEM), and minimal detectable change (MDC) of frontal plane projection angles (FPPAs) across five single-leg tasks in individuals with patellofemoral pain (PFP). Two-dimensional video data was collected from ten individuals with predominantly unilateral PFP. Participants performed single-leg squat, single-leg landing, single-leg hop, forward step-down, and lateral step-down across two testing sessions. FPPAs were measured at peak knee flexion for each task, including trunk lean angle, knee FPPA, hip FPPA, and dynamic valgus index. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs). Our findings indicate that test–retest reliability and measurement error for trunk and lower limb FPPA varied across tasks in individuals with PFP. The lowest ICC was observed for hip FPPA, particularly during single-leg squat and lateral step-down tasks. Among the five tasks tested, the single-leg squat appeared to be the most demanding task, demonstrating the lowest ICCs, and highest SEM and MDC values across all four outcome measures (trunk lean angle, knee and hip FPPAs, and dynamic valgus index). The dynamic valgus index consistently showed larger SEM and MDC values than isolated hip or knee FPPAs, likely reflecting compounded measurement errors across segments. These findings provide preliminary insights, though confirmation in larger samples in persons with PFP is warranted. Full article

Background: Plantar pressure analysis provides insight into load distribution at the foot–pedal interface during cycling; however, its modulation by pedaling power, cadence, and overuse injury status remains poorly understood by professional cyclists. It is unclear whether common overuse injuries, such as Achilles tendinopathy, patellofemoral pathology, and iliotibial band syndrome, are associated with distinct plantar loading patterns. This study aimed to characterize plantar pressure distribution in elite cyclists and determine how power, cadence, and injury status influence this pattern. Methods: Professional cyclists completed a single integrated protocol using a high-resolution in-shoe pressure system. Plantar forces were recorded across nine anatomical regions and grouped into the transverse and longitudinal segments of the foot. Three phases were included: absolute power manipulation (100 and 200 W), cadence manipulation (80 and 100 rpm) at fixed power, and an ecological combined protocol using relative power (1.5 and 3 W·kg⁻¹) with individualized cadence. The cyclists used their habitual bike setups. Participants were classified into the non-pathological (NP), AT, PFP, or ITBS groups. Mixed repeated-measures ANOVAs were used to analyze the effects of power, cadence, zone, foot, and injury status. Results: The plantar pressure distribution was consistently dominated by the medial forefoot. Increasing the absolute power from 100 to 200 W increased the maximal plantar pressures by 84.74% (p < 0.001), whereas increasing the cadence from 80 to 100 rpm at a fixed power increased the pressures by 15.90% (p = 0.003). Under individualized conditions, increasing relative power from 1.5 to 3 W·kg⁻¹ increased pressures by 39.59% (p < 0.001), whereas cadence had no global main effect but significantly altered the regional pressure distribution (p < 0.001). Injury groups showed pathology-specific deviations, including higher overall pressures and asymmetry in Achilles tendinopathy, bilateral asymmetry in patellofemoral pathology, and asymmetric loading patterns in iliotibial band syndrome. Conclusions: Power is the main determinant of plantar pressure, and cadence modulates load distribution. Overuse injuries induce pathology-specific pressure patterns, supporting plantar pressure analysis for injury prevention and performance optimization in athletes. Full article

Background: Digital health has accelerated telehealth uptake, yet evidence comparing video-based musculoskeletal assessment with traditional in-person examination is limited. This study evaluated the concurrent validity and interrater reliability of video-based physiotherapy assessment versus face-to-face assessment in patients with knee pain. Methods: Patients with knee pain underwent randomized consecutive in-person and video-based assessments by experienced musculoskeletal physiotherapists. Clinical diagnoses were categorized into seven groups (red flag, yellow flag, arthrogenic, tendinopathy, patellofemoral pain, muscle sprain, neurogenic). Primary outcomes were intermethod agreement and Cohen’s kappa; sensitivity, specificity, PPV, NPV, and interrater reliability for video assessments were also reported. Results: Forty-five participants (mean age 38 ± 6.5 years; 55.6% female) completed the study. In-person and video-based assessments produced identical diagnoses in 43/45 cases (Cohen’s κ = 0.92, p < 0.001). Telehealth accuracy was high across all diagnostic categories (90–100%). Interrater agreement between video-based assessors was 93.3% (κ = 0.89, p < 0.001). Agreement between assessments was moderately associated with KOOS (r = 0.312, p = 0.037). Conclusions: In this selected pragmatic sample, video-based physiotherapy assessment demonstrated high concurrent agreement and excellent interrater reliability with face-to-face assessment. Given the study’s sample size, repeated-measures design, and lack of an independent reference standard, these results indicate feasibility and intermethod agreement rather than diagnostic equivalence. Video assessment may be a feasible option for triage and management in selected settings, but further research in larger, more diverse populations and evaluation against independent reference standards is required. Full article

Patellar maltracking is among the most common causes of anterior knee pain after total knee arthroplasty (TKA), underscoring the need for accurate prevention and treatment. Therefore, the purpose of this narrative review is to provide a comprehensive overview of current evidence on post-TKA tracking, focusing on component alignment, preoperative patient assessment, and revision treatment options. A PubMed database search was performed, leveraging the literature from the last 20 years, and the results were qualitatively synthesized. According to current studies, several precautions should be taken to prevent patellofemoral stress and, consequently, patellar maltracking, such as avoiding internal rotation, valgus alignment, and excessive flexion of the femoral component and internal rotation of the tibial component. Regarding alignment strategies, kinematic alignment appears to offer potential benefits over mechanical alignment in certain functional outcomes and patient satisfaction scores. However, these differences should be interpreted cautiously as they may not always exceed the minimal clinically important difference. Furthermore, recent evidence indicates that quadriceps biomechanics influence TKA outcomes, potentially suggesting that conventional surgical approaches may need to be individualized, though these preliminary findings require prospective validation. Currently, robotic-assisted surgery represents a developmental direction for patient-tailored interventions and offers great promise for better prosthesis customization to the individual patient. Integration of imaging data with dynamic soft-tissue assessment enables more predictable reconstruction of joint kinematics. Regarding surgical treatment, the selection of specific methods requires a prior clinical and radiographic assessment. Indications range from patellar maltracking direction and component malrotation to patient preferences and rehabilitation potential. Ultimately, the future of TKA relies on personalized interventions to prevent complications and improve patient outcomes. This evolution is driven by the shift from mechanical alignment to kinematic alignment, alongside quadriceps tendon assessment and intraoperative robotic-assisted measurement, all aimed at optimizing the accuracy of implant positioning. Full article

Background and Objectives: Medial unicompartmental knee arthroplasty (UKA) has emerged as an effective surgical option for isolated medial compartment osteoarthritis (OA), offering advantages in bone preservation, knee kinematics, and postoperative recovery compared with total knee arthroplasty (TKA). Although numerous studies have evaluated the mid- to long-term outcomes of UKA, reports focusing on cohorts with follow-up periods exceeding 10 years remain relatively limited. The purpose of this study was to analyze the long-term clinical and radiological results of medial fixed-bearing UKA using the Miller-Galante prosthesis. Methods: Sixty-eight patients who underwent UKA at a single institution with at least 10 years of follow-up were retrospectively reviewed. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and knee range of motion (ROM). Radiological parameters including the hip-knee-ankle axis angle (HKA) and osteoarthritis (OA) grade using the Kellgren-Lawrence (K-L) grading system were evaluated. Implant survivorship was evaluated using Kaplan–Meier survival analysis. Results: A total of 68 patients were included with a mean age of 56.8 ± 7.5 years at surgery and a mean follow-up of 170.9 ± 37.3 months. Significant improvement in the WOMAC score was observed from 48.9 ± 17.2 preoperatively to 23.8 ± 27.7 at final follow-up (p = 0.002). The cumulative survival rates were 97.1% at 10 years and 84.8% at 15 years with conversion to total knee arthroplasty as the endpoint. Significant improvement in the HKA was observed from 172.5° ± 4.4° to 174.3° ± 4.8° postoperatively (p = 0.002), though residual varus alignment persisted. Progressive OA was observed in the lateral tibiofemoral and patellofemoral compartments (both p < 0.001) but showed no correlation with the WOMAC score. The failure group showed trends toward higher body mass index (BMI) and smaller preoperative HKA angle compared to the non-failure group. Conclusions: The long-term outcomes of medial fixed-bearing UKA using the Miller–Galante prosthesis were generally favorable, with significant functional improvement and acceptable implant survivorship. Although overall varus alignment was corrected, some residual varus deformity remained, and OA progression was observed in the lateral tibiofemoral and patellofemoral compartments over time. However, given the retrospective design and limited sample size, these findings should be interpreted with caution. Full article

Excessive external tibial torsion (ETT) is a recognized cause of anterior knee pain (AKP). In patients with excessive ETT, placing the foot forward during gait causes the knee joint to point inward, increasing the Q-angle and the lateral quadriceps vector. In appropriately selected cases, internal rotational tibial osteotomy is a reliable treatment option for symptomatic excessive ETT, yielding favorable outcomes with minimal complications. Nevertheless, no universally accepted torsion threshold exists to guide surgical decision-making, and evidence remains limited regarding the optimal anatomic level for performing the osteotomy. Full article

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that involves various biomechanical factors, including the altered positioning of the patella, weakness of the lower extremity muscles, delayed activation of the vastus medialis muscle, and excessive pronation of the foot. Although the short- and long-term effects of external support among the recommended conservative treatment methods for PFPS have been examined, there remains a lack of consensus regarding their impacts. This study was conducted to investigate the immediate effects of braces and rigid taping applied to control pain on proprioception, functional status, and balance in patients with PFPS, and to compare these outcomes with normative values obtained from healthy individuals. Methods: The study included 18 patients with PFPS and 18 healthy individuals who met the inclusion criteria. Through randomization of the intervention sequence, patients were evaluated under conditions of rigid taping, support, or without any support. Their pain levels before and after the application were assessed using the Visual Analog Scale; their functional status was evaluated with the Kujala Patellofemoral Scoring, the 10-Step Up Test, and the Squat; their balance performance was measured using the Y-Balance Test and the Single Leg Stance Test; and their proprioception was assessed with the Joint Position Sense Test. Results: It has been determined that rigid taping and bracing have similar effects in the immediate management of pain, proprioception, functional status, and balance issues in patients with PFPS. The interventions were observed to bring patients’ static balance and proprioception parameters closer to the values seen in healthy individuals. Conclusions: Rigid taping and bracing are both effective interventions in the management of PFPS, offering benefits such as pain relief, prevention of proprioceptive deficits, mitigation of balance impairments, and enhancement of functional outcomes. The selection of the most appropriate modality should be based on the individual patient’s characteristics and tolerance levels. Full article

Background/Objectives: The benefit of patellar resurfacing (PR) in total knee arthroplasty (TKA) remains controversial. No previous study has examined the impact of PR in valgus osteoarthritis (OA) with compromised patellofemoral joint (PFJ) status. Methods: We retrospectively reviewed 2250 primary TKAs performed between 2011 and 2025. Among 152 valgus OA cases, 87 had compromised PFJ status, defined as Outerbridge grade 3–4 chondral damage or patellar tilt >10° on Merchant-view radiographs. Two surgeons with identical protocols operated during overlapping periods; one typically performed PR (n = 47) and the other did not (n = 40). Primary outcomes included the American Knee Society (AKS) score and Kujala Anterior Knee Pain Scale. Secondary outcomes included radiologic measures (HKA angle, patellar tilt, and lateral patella shift) and patellar-related complications (crepitus, fracture, subluxation, and maltracking). Results: At a mean follow-up of 7.1 years in the non-PR group and 6.5 years in the PR group, no significant differences were observed between groups in KSS function scores (non-PR 92.4 ± 3.5 vs. PR 93.0 ± 4.6, p = 0.54) or Kujala scores (non-PR 76.9 ± 3.5 vs. PR 77.7 ± 4.2, p = 0.33). Both patellar tilt and lateral patella shift showed slight postoperative reductions, but no significant difference was observed between groups (patellar tilt: non-PR 5.4° ± 0.8° vs. PR 5.7° ± 0.6°, p = 0.11; lateral patella shift: non-PR 2.4 ± 0.6 mm vs. PR 2.3 ± 0.7 mm, p = 0.75). Patellar-related complications were infrequent and showed no significant differences. Conclusions: Overall, PR did not demonstrate superior outcomes compared with non-PR in valgus OA patients with compromised PFJ status at mid-term follow-up. Full article

Knee biomechanical demands vary across different sports due to sport- and position-specific patterns of muscle recruitment. To return to performance, athletes must adequately restore knee kinematics to regain control over the same sport mechanics that led to the initial anterior cruciate ligament (ACL) injury. ACL graft selection should therefore minimize donor site morbidity and support sport-specific demands. This study aims to address the available evidence and guide surgical graft choice in athletes. A literature search of PubMed, MEDLINE, Scopus, and Web of Science (up to September 2025) assessed BPTB, hamstring, and quadriceps tendon autografts. Outcomes included revision, graft survival, return to sport, time to return, PROMs, anterior knee pain, donor site morbidity, and prognostic factors (age, sex). Sports were classified as pivoting, contact/collision, or endurance/non-pivoting. The results were synthesized narratively. In pivoting and cutting sports, bone–patellar tendon–bone (BPTB) autografts offer high survival rates but are associated with a high incidence of anterior knee pain, which is a substantial drawback in kneeling or flexion-intensive sports. Hamstring tendon (HT) grafts carry higher revision rates in female and younger patients, though they have low donor site morbidity that does not appear to affect long-term athletic performance. Quadriceps tendon (QT) grafts are emerging as a promising option for pivoting athletes. However, conflicting results indicate that the revision risk is comparable to that of HT grafts and possible long-standing extensor mechanism weakness. Contact and collision sports demonstrate similar trends, but kneeling and contact injuries are more common in this group. Thus, while prioritizing powerful hamstring strength, anterior knee pain symptoms should still be carefully considered. The diameter of the HT autograft should exceed 7.5 mm to ensure comparable revision outcomes with BPTB. QT grafts remain a limited-evidence attractive option. Endurance and non-pivoting athletes require fewer pivoting mechanics but rely heavily on muscle symmetry and repetitive motion. BPTB grafts are less suitable in this category due to alterations in sprint mechanics, muscle asymmetry, and repetitive patellofemoral joint loading. HT grafts provide favorable rates of return to sport, whereas evidence regarding QT graft use in non-pivoting athletes remains limited. Full article

The aim of this research was to identify the 50 articles most frequently referenced concerning patellofemoral instability (PFI) and to analyze their features. A search was performed in the Thomson ISI Web of Science using keywords such as “patellofemoral instability,” “patellar instability,” “patellar dislocation,” and “patella luxation.” This research included all publications related to PFI, covering aspects such as diagnostic and both nonoperative and operative treatment. The citation counts for the 50 articles ranged from 165 to 1024 citations. Notably, the top ten articles received a minimum of 348 citations each. In total, 84% (n = 42) of the studies were clinical, while the remainder consisted of basic science investigations (including three anatomical and five biomechanical studies). The predominant level of evidence was IV, accounting for 32%. The American Journal of Sport Medicine was responsible for publishing 34% of these articles. Most of the research took place in the United States and twelve additional countries. The years when the most-referenced papers were published spanned from 1985 to 2020, with the 2000s representing the highest share of articles (74%), and the years between 2006 and 2010 showing the peak quantity of articles (n = 15). This article provides a building block in the PFI management. The selection of these articles is useful for learning more about current trends on PFI and anticipating future developments. Full article