Patellofemoral pain is a nonspecific medical term referring to pain in the front of the knee.
This syndrome can occur for several reasons and is found in a variety of different patient types. “Runner’s knee” is a term typically used to describe patellofemoral pain in athletes.
Patellofemoral pain can also be very common in non-athletic patients who experience discomfort in their knees with activities such as stair climbing, squatting, prolonged sitting, and kneeling.
Making the proper diagnosis regarding the reason for the patellofemoral pain is critical in accurately treating this difficult complex knee problem. Neglecting early treatment of patellofemoral pain can often result in permanent damage to the patella cartilage and result in the development of early arthritis.
The knee joint is made up of 3 bony structures: the femur or thigh bone, the tibia or leg bone, and the patella or kneecap. Patellofemoral pain typically involves problems associated with the patella and the area of the femur where it makes contact.
The patella is a floating bone located within the quadriceps (thigh) muscle group. The patella is covered on its undersurface by a smooth cartilage covering which glides against the cartilage on the femur bone with bending of the knee. The patella tendon attaches the patella to the tibia bone.
Patellofemoral pain frequently begins as a result of soft tissue inflammation surrounding the front of the knee. It may also involve a gradual breakdown of the cartilage underneath the knee cap commonly referred to as “chondromalacia patella”. As the cartilage damage progresses with time, patellofemoral arthritis can occur.
Factors that contribute to these conditions include:
- malalignment of the patella and/or hips
- muscle or ligament imbalance
- trauma (direct blow to the knee or a dislocation of the patella)
- flat feet
- age (softening and gradual deterioration of the cartilage with repetitive use)
Patellofemoral pain begins with a dull aching pain over the front of the knee with sitting, stair climbing, squatting, kneeling, or running/ jumping activities. Sharp pain and/or swelling can be a sign of significant cartilage damage.
You doctor will take a history from you regarding your pain and will perform a thorough examination of you knee. X-rays are an important part of the examination. Often, an MRI will be ordered to better evaluate the soft tissue structures of the knee joint such as the cartilage, ligament, and meniscal tissues.
Non operative treatment consists initially of ice, rest, and anti-inflammatory medications. Physical therapy may also be prescribed. Other options can include: taping, bracing, and shoe inserts.
Operative treatment depends on the pathology determined by your doctor. Most conditions can be treated with Arthroscopy. This involves a minimally invasive