Patellofemoral pain: It’s commonly diagnosed, but what is it?
By Doug Haltom, M.D.
The patella (kneecap) and the femur (thigh bone) combine at the knee to form what is called the patellofemoral joint. When the knee flexes or bends, a complex motion occurs as the patella glides in a groove of the femur and increasing forces are transmitted across this joint.
Patellofemoral pain or “anterior knee pain” are terms used to describe pain and dysfunction of the anterior or front of the knee. It is a frequent clinical problem and can be challenging to treat. It can affect any age group and gender, but it does seem to affect females more often.
Symptoms can include both pain and instability. Pain around the patella is usually worse with squatting, climbing stairs or sitting with the knee bent for an extended period of time.
True instability occurs when the patella either dislocates or shifts laterally. This is usually traumatic and causes swelling.
This is not to be confused with the knee “giving way” or buckling in which the knee collapses into flexion or ino a bent position. This is usually due to an insufficiency in the thigh muscle and can be secondary to pain, weakness or swelling of the joint.
Treatment of patellofemoral pain varies and depends on the underlying cause of the pain. The vast majority of cases, however, are usually related to overuse and respond well to rest, anti-inflammatories and avoiding the offending activities.
Physical therapy is a mainstay of treatment. Exercises that focus on thigh muscles, hip muscles and core muscles can be very beneficial. Taping, bracing and even shoe orthotics also can be used.
Surgery is reserved for those cases that don’t respond to conservative treatment and consist of procedures that realign the patella, stabilize the patella or release or lengthen the tight structures around the patella.
It is important to remember, however, that the vast majority of patients respond extremely well to conservative, nonsurgical treatment!