Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome Melbourne Knee Surgery

What is patellofemoral pain syndrome?

Patellofemoral pain syndrome (PFPS) is a broad term used to describe patients with pain at the front of their knee and around or under the kneecap. This pain occurs in the absence of any cartilage problems involving the kneecap.

What are the symptoms of patellofemoral pain syndrome?

The pain is usually exacerbated by activities that put excessive pressure on the patella (kneecap) such as walking up or down stairs, lunging, squatting, or jogging. It can also be caused by a sudden change in activity frequency or intensity, as the body has not had enough time to compensate for this change.

How do you treat patellofemoral pain syndrome?

The management of PFPS is largely non-operative.

Weakness of the core, gluteal, and quadriceps muscles can lead to medial collapse of the knee as it is loaded into flexion. This can cause abnormal pressure transmission to the cartilage outside the patella, which will generate pain. This pain can be exacerbated with overuse such as increasing the duration or frequency of exercise or activity performed.

Weakness of each of these muscle groups can easily be identified by clinical examination. Patients with medial collapse will usually benefit from a course of targeted physiotherapy aimed at providing a graded strengthening program for those muscle groups. Although symptomatic and functional gains will be made, it requires patient compliance and persistence with the physiotherapy regime, as sometimes its benefits can take as long as twelve months to become apparent. 

Other non-operative measures include:

  • Rest from aggravating activity

  • Taping for short-term relief

  • Foot orthotics

  • Weight loss to decrease force across the patellofemoral joint 

There are structural reasons why some patients get PFPS. These prevent the patella from tracking centrally in the groove (trochlea). Issues with the alignment or rotation of the lower limb can make the patella track off-center and change the loading pressure of the cartilage. This can also cause inflammation of the fat pad beneath the patella.