The patellofemoral has been difficult to diagnose for many years. Treatments range from conservative therapy to surgery. It is now known that patellofemoral pain has many causes. Conservative therapy usually resolves pain no matter what the pain is caused from. There are many terms for patellofemoral syndrome, describing knee patella pain. Terms such as petellagia, patellar malalignment syndrome, and patellofemoral compression syndrome all describe the same problem. The definition of patellofemoral syndrome is anterior knee pain in the joint between the patella and the patellofemoral groove.
Common characteristics of patients with patellofemoral syndrome include increased Q angle, internal tibial rotation, patellar instability, pes planus, and pain when the patella is compressed with the femur. A tight iliotibial band or hamstrings can also contribute to a problem.
A typical patient with patellofemoral syndrome is a young adult with chronic knee pain. This can be brought on by going up and down stairs, jumping, or running. The pain can be relieved by rest and ice. The patient is not necessarily athletic. Osgood-Schlatter disease can also increase your chances of getting this syndrome. When the patient is younger than 17 the knee pain is usually acute and often bilateral. If the pain is due to chondromalacia, the patients tends to be older than 20, with past trauma and swelling.
When diagnosing patellofemoral syndrome lateral knee x-rays are useful, if pain is suspected due to osteoarthritis. Axial view x-rays in 30, 60, and 90 degrees of flexion can detect partial dislocation. MRI's will show soft tissue to find what may be wrong with the patellofemoral joint.
Using conservative therapy is usually successful in treating 82% of patients, but frequently comes back. Therapy includes rest, limiting motion, and strengthening the quadriceps muscle. Especially therapy of the vastus medialis. Antiinflammatory medications help to decrease inflammation. Ice and ultrasound can also be helpful. If surgery is necessary there are different procedures that may be used. These include a patellar lateral release, patellar realignment, or a tibial tubercle transfer.
The source of most patellofemoral pain are changes in the structure of the anterior knee, which the most recent research points to. But not all people with symptoms do. Future research could be very beneficial in making patellofemoral syndrome clearer to identify.