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A patient presents to an outpatient clinic with complaints of right knee pain. The referral states that the patient had stem cell injections four weeks ago. Which diagnosis would MOST likely benefit from this type of intervention?

1. Osteoarthritis
2. Patellofemoral pain syndrome
3. Anterior cruciate ligament sprain (grade 3)
4. Prepatellar bursitis

Welcome back to the Scorebuilders’ Q and A Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

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A patient presents to an outpatient clinic with complaints of right knee pain. The referral states that the patient had stem cell injections four weeks ago. Which diagnosis would MOST likely benefit from this type of intervention?

1. Osteoarthritis
2. Patellofemoral pain syndrome
3. Anterior cruciate ligament sprain (grade 3)
4.  Prepatellar bursitis

Stem Cells
Stem cells are the unspecialized, undifferentiated, immature cells that divide and differentiate into specific types of cells and tissues. Once differentiated, stem cells can replace damaged tissues to become tissue-specific or organ-specific cells with specialized functions. 

Stem cells can be implanted into the target tissue or organ to initiate tissue regeneration. The use of stem cells has been shown to be beneficial in the treatment of many degenerative and inflammatory conditions.

The question is asking which diagnosis would most likely benefit from stem cell injections.

Let’s explore each of the options:

Option 1 - Osteoarthritis
Osteoarthritis is a chronic disease that causes degeneration of articular cartilage, primarily in weight bearing joints. Subsequent deformity and thickening of subchondral bone occurs resulting in impaired functional status. 

Stem cell injections are most commonly used in the treatment of osteoarthritis since they can help to regenerate new cartilage cells.

Option 2 - Patellofemoral pain syndrome 
Patellofemoral pain syndrome is a general term describing pain or discomfort in the anterior knee. It’s a repetitive overuse disorder resulting from increased force at the patellofemoral joint.

Possible treatment options for patellofemoral pain syndrome include lower extremity strengthening and flexibility exercises, medial patella glides, foot orthoses, and patella taping. Stem cell injections would not be used to treat this condition.

Option 3 - Anterior cruciate ligament sprain (grade 3)
The anterior cruciate ligament prevents anterior translation of the tibia on the fixed femur and posterior translation of the femur on the fixed tibia. A grade III anterior cruciate ligament sprain refers to a complete tear of the ligament with excessive laxity. A patient with a complete tear of their anterior cruciate ligament will typically require surgery to repair the torn ligament. 

Stem cell injections would not be beneficial for this type of injury.

Option 4 - Prepatellar bursitis
The prepatellar bursa is located at the front of the patella Bursitis is a condition caused by acute or chronic inflammation of a bursa.

Bursitis is typically treated conservatively with rest, ice, physical therapy, and anti-inflammatory drugs. In cases that do not respond to conservative treatment, a steroid injection may be necessary. Stem cell injections would not be used to treat this condition.

The correct answer to this question is Option 1

Let’s explore the all student data:
66% of students selected Option 1, Osteoarthritis, the correct response
6% of students selected Option 2, Patellofemoral pain syndrome
21% of students selected Option 3, Anterior cruciate ligament sprain (grade 3)
7% of students selected Option 4, Prepatellar bursitis

System Classification
This question is a Musculoskeletal Systems question which represents approximately 27% of all exam items.

Content Outline Classification
This question is a Foundations for Evaluation, Differential Diagnosis, and Prognosis question which represents approximately 33% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 131-132 and 178-179 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!