{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T06:53:34Z","timestamp":1794293614033,"version":"4.9.0"},"reference-count":56,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2018,8,6]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patellofemoral pain (PFP) is a prevalent condition commencing at various points throughout life. We aimed to provide an evidence synthesis concerning predictive variables for PFP, to aid development of preventative interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched Medline, Web of Science and SCOPUS until February 2017 for prospective studies investigating at least one potential risk factor for future PFP. Two independent reviewers appraised methodological quality using the Newcastle\u2013Ottawa Scale. We conducted meta-analysis where appropriate, with standardised mean differences (SMD) and risk ratios calculated for continuous and nominal scaled data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This review included 18 studies involving 4818 participants, of whom 483 developed PFP (heterogeneous incidence 10%). Three distinct subgroups (military recruits, adolescents and recreational runners) were identified. Strong to moderate evidence indicated that age, height, weight, body mass index (BMI), body fat and Q angle were not risk factors for future PFP. Moderate evidence indicated that quadriceps weakness was a risk factor for future PFP in the military, especially when normalised by BMI (SMD \u22120.69, CI \u22121.02, \u20130.35). Moderate evidence indicated that hip weakness was not a risk factor for future PFP (multiple pooled SMDs, range \u22120.09 to \u22120.20), but in adolescents, moderate evidence indicated that increased hip abduction strength was a risk factor for future PFP (SMD 0.71, CI 0.39, 1.04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This review identified multiple variables that did not predict future PFP, but quadriceps weakness in military recruits and higher hip strength in adolescents were risk factors for PFP. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2017-098890","type":"journal-article","created":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T13:54:46Z","timestamp":1537538086000},"page":"270-281","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":212,"title":["Risk factors for patellofemoral pain: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"53","author":[{"given":"Bradley S","family":"Neal","sequence":"first","affiliation":[{"name":"Sports and Exercise Medicine, Queen Mary University of London, London, UK"},{"name":"Pure Sports Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1732-9606","authenticated-orcid":false,"given":"Simon D","family":"Lack","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, Queen Mary University of London, London, UK"},{"name":"Pure Sports Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke E","family":"Lankhorst","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Raye","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, Queen Mary University of London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Sports and Exercise Medicine, Queen Mary University of London, London, UK"},{"name":"Physiotherapy Department, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marienke","family":"van Middelkoop","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,9,21]]},"reference":[{"key":"2025080114584614000_53.5.270.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096384"},{"key":"2025080114584614000_53.5.270.2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-14-225"},{"key":"2025080114584614000_53.5.270.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0838.2009.00996.x"},{"key":"2025080114584614000_53.5.270.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0190892","article-title":"Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis","volume":"13","author":"Smith","year":"2018","journal-title":"PLoS One"},{"key":"2025080114584614000_53.5.270.5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ptsp.2006.07.001","article-title":"Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated?","volume":"8","author":"Callaghan","year":"2007","journal-title":"Physical Therapy in Sport"},{"key":"2025080114584614000_53.5.270.6","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-201"},{"key":"2025080114584614000_53.5.270.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093445"},{"key":"2025080114584614000_53.5.270.8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-094664"},{"key":"2025080114584614000_53.5.270.9","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-199214020-00002"},{"key":"2025080114584614000_53.5.270.10","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3803"},{"key":"2025080114584614000_53.5.270.11","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-098717"},{"key":"2025080114584614000_53.5.270.12","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-014-0055-4"},{"key":"2025080114584614000_53.5.270.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2015.11.018"},{"key":"2025080114584614000_53.5.270.14","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-014-0053-6"},{"key":"2025080114584614000_53.5.270.15","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00136"},{"key":"2025080114584614000_53.5.270.16","unstructured":"Wells G , Shea B , O\u2019connell D , et al , 2008. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http. ohri. ca\/programs\/clinical_epidemiology\/oxford. asp (accessed Jun 2014)."},{"key":"2025080114584614000_53.5.270.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(96)00236-3"},{"key":"2025080114584614000_53.5.270.18","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200838090-00005"},{"key":"2025080114584614000_53.5.270.19","doi-asserted-by":"publisher","DOI":"10.1002\/sim.650"},{"key":"2025080114584614000_53.5.270.20","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200306150-00014"},{"key":"2025080114584614000_53.5.270.21","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509337934"},{"key":"2025080114584614000_53.5.270.22","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3810\/psm.2012.02.1947","article-title":"Is body composition associated with an increased risk of developing anterior knee pain in adolescent female athletes?","volume":"40","author":"Barber Foss","year":"2012","journal-title":"Phys Sportsmed"},{"key":"2025080114584614000_53.5.270.23","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.2106\/00004623-199173070-00012","article-title":"Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits","volume":"73","author":"Milgrom","year":"1991","journal-title":"J Bone Joint Surg Am"},{"key":"2025080114584614000_53.5.270.24","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508331135"},{"key":"2025080114584614000_53.5.270.25","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3233\/IES-2008-0311","article-title":"Isokinetic assessment of patellofemoral pain syndrome: a prospective study in female recruits","volume":"16","author":"Duvigneaud","year":"2008","journal-title":"Isokinetics and Exercise Science"},{"key":"2025080114584614000_53.5.270.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2011.04.007"},{"key":"2025080114584614000_53.5.270.27","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515599628"},{"key":"2025080114584614000_53.5.270.28","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B7.17826"},{"key":"2025080114584614000_53.5.270.29","doi-asserted-by":"crossref","first-page":"188-","DOI":"10.1111\/sms.12633","article-title":"Two-dimensional knee valgus displacement as a predictor of patellofemoral pain in adolescent females","volume":"27","author":"Holden","year":"2017","journal-title":"Scand J Med Sci Sports"},{"key":"2025080114584614000_53.5.270.30","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1249\/MSS.0000000000000890","article-title":"Influence of step rate on shin injury and anterior knee pain in high school Runners","volume":"48","author":"Luedke","year":"2016","journal-title":"Medicine & Science in Sports & Exercise"},{"key":"2025080114584614000_53.5.270.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2010.04.001"},{"key":"2025080114584614000_53.5.270.32","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31828249d2"},{"key":"2025080114584614000_53.5.270.33","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2519\/jospt.2015.5091","article-title":"High eccentric hip abduction strength reduces the risk of developing patellofemoral pain among novice runners initiating a self-structured running program: a 1-year observational study","volume":"45","author":"Ramskov","year":"2015","journal-title":"J Orthop Sports Phys Ther"},{"key":"2025080114584614000_53.5.270.34","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.046649"},{"key":"2025080114584614000_53.5.270.35","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511407617"},{"key":"2025080114584614000_53.5.270.36","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e31815ac44f"},{"key":"2025080114584614000_53.5.270.37","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3233\/IES-2004-0178","article-title":"Analysis of isokinetic parameters in the development of anterior knee pain syndrome: a prospective study in a military setting","volume":"12","author":"Van Tiggelen","year":"2004","journal-title":"Isokinetics and Exercise Science"},{"key":"2025080114584614000_53.5.270.38","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1177\/03635465000280040701","article-title":"Intrinsic risk factors for the development of anterior knee pain in an athletic population a two-year prospective study","volume":"28","author":"Witvrouw","year":"2000","journal-title":"Am J Sports Med"},{"key":"2025080114584614000_53.5.270.39","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0079153","article-title":"Hip and knee strength is not affected in 12-16 year old adolescents with patellofemoral pain\u2013a cross -sectional population-based study","volume":"8","author":"Rathleff","year":"2013","journal-title":"PLoS One"},{"key":"2025080114584614000_53.5.270.40","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093305"},{"key":"2025080114584614000_53.5.270.41","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2011-090369"},{"key":"2025080114584614000_53.5.270.42","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.4184"},{"key":"2025080114584614000_53.5.270.43","doi-asserted-by":"crossref","first-page":"b4074","DOI":"10.1136\/bmj.b4074","article-title":"Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial.","volume":"339","author":"van Linschoten","year":"2009","journal-title":"BMJ (Clinical Research Edn)"},{"key":"2025080114584614000_53.5.270.44","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-093929"},{"key":"2025080114584614000_53.5.270.45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1123\/jab.2016-0333","article-title":"Sex-Specific Relationships between\u00a0hip strength and hip, pelvis, and trunk kinematics in healthy runners","volume":"34","author":"Hannigan","year":"2018","journal-title":"J Appl Biomech"},{"key":"2025080114584614000_53.5.270.46","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515622456"},{"key":"2025080114584614000_53.5.270.47","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510393269"},{"key":"2025080114584614000_53.5.270.48","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096768"},{"key":"2025080114584614000_53.5.270.49","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ptsp.2017.07.002","article-title":"Physical activity levels in individuals with and without patellofemoral pain","volume":"27","author":"Glaviano","year":"2017","journal-title":"Physical Therapy in Sport"},{"key":"2025080114584614000_53.5.270.50","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-150-04-07"},{"key":"2025080114584614000_53.5.270.51","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/03635465990270050701","article-title":"The effect of foot structure and range of motion on musculoskeletal overuse injuries","volume":"27","author":"Kaufman","year":"1999","journal-title":"Am J Sports Med"},{"key":"2025080114584614000_53.5.270.52","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096705"},{"key":"2025080114584614000_53.5.270.53","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2015-095850"},{"key":"2025080114584614000_53.5.270.54","doi-asserted-by":"publisher","DOI":"10.1023\/A:1009979306346"},{"key":"2025080114584614000_53.5.270.55","doi-asserted-by":"publisher","DOI":"10.1214\/09-AOAS285"},{"key":"2025080114584614000_53.5.270.56","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2014.5164"}],"container-title":["British Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjsports-2017-098890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T21:58:57Z","timestamp":1754085537000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjsm.bmj.com\/lookup\/doi\/10.1136\/bjsports-2017-098890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,21]]},"references-count":56,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,2,19]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bjsports-2017-098890"],"URL":"https:\/\/doi.org\/10.1136\/bjsports-2017-098890","relation":{},"ISSN":["0306-3674","1473-0480"],"issn-type":[{"value":"0306-3674","type":"print"},{"value":"1473-0480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,21]]}}}