Patellofemoral Pain Syndrome

Department of Medicine & Rehabilitation and Sport Medicine, University Hospital la Timone, Boulevard Jean Moulin, 13005 Marseille, France.
Clinics in sports medicine (Impact Factor: 1.22). 07/2010; 29(3):379-98. DOI: 10.1016/j.csm.2010.03.012
Source: PubMed

ABSTRACT Patellofemoral pain (PFP) syndrome is a frequently encountered overuse disorder that involves the patellofemoral region and often presents as anterior knee pain. PFP can be difficult to diagnose. Not only do the etiology, diagnosis, and treatment remain challenging, but the terminology used to describe PFP is used inconsistently and can be confusing. Patellofemoral pain syndrome (PFPS) seems to be multifactorial, resulting from a complex interaction among intrinsic anatomic and external training factors. Although clinicians frequently make the diagnosis of PFPS, no consensus exists about its etiology or the factors most responsible for causing pain. This article discusses the pathophysiology, diagnosis, and management of PFP.

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    • "Our study focused on vastus medialis oblique muscle. The role of the VMO among the thigh quadriceps muscle is mainly reported in the studies on the patellofemoral pain disorders, where the weakening of the VMO allows the patella to track too far laterally and causes the malalignment of the patella and abnormal lateral displacement.[3435] In literature, the effect of various exercises on muscle strength was investigated on specific muscles. "
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    ABSTRACT: Background: This investigation compared the effects of exercise rehabilitation and bracing on muscle flexibility and strength as well as knee proprioception and pain in female sufferers of lateral displacement of patella (LDP). Materials and Methods: Twenty-two females with unilateral LDP were randomly divided into two groups to receive exercises (n = 12) or patellar brace (n = 10). Both groups were evaluated before and after 8 weeks with isokinetic dynamometer (Biodex System 3 Pro) for muscle strength and proprioception, with SLR, Active Knee Flexion, and Sit and Reach tests for flexibility assessment and with a visual analog scale for pain. Results: Muscle flexibility in both exercise and bracing groups improved (F(1,20)≥5.99 and P ≤ 0.024), whereas improvement in bracing group was not significant. Significant interaction was observed in favor of exercise group in 2 strength tests of knee flexion and knee extension (F(1,20)≥6.564 and P ≤ 0.019). For proprioception, a significant interaction was observed in favor of bracing group (F(1,20) =7.944 and P = 0.011). Also the results showed both exercise rehab and brace decreased significantly pain severity during stair ascending and descending. Conclusion: These results suggest that better flexibility and more strength in exercise group somehow reduced the stress on patellofemoral joint and it, in turn, alleviated the symptoms and pain. It is also likely that relieving effects of brace and improvement of proprioception by it allows patients to be more physically active and it could have, more or less, effects similar to exercise. Therefore both exercise and brace could be prescribed for patients with LDP. It seems application of the patellar brace combined with exercise might be a better treatment for these patients, because they could improve strength, flexibility and proprioception.
    08/2014; 3:165. DOI:10.4103/2277-9175.139128
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    • "Hence, clinical assessment of patients with anterior knee pain is challenging and crucial, since an event of patellar maltracking like LPD is missing and several risk factors as osseous stability, lateral muscular vector force, ligamentous instability or constraint and torsional disadvantages need to be addressed or compensated. Origin of the pain can be the synovium, the patella, its aponeurosis, the fat pad, the tendinous, retinacular and ligamentous insertions, or in young patients also hip disorders.61 "
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    ABSTRACT: Patellofemoral instability not only involves lateral patellar dislocation, patellar mal-tracking or subluxation but can also cause a limiting disability for sports activities. Its underlying causes are known as morphological anomalies of the patellofemoral joint or the mechanical axis, femorotibial malrotation, variants of the knee extensor apparatus, and ligamentous insufficiencies often accompanied by poor proprioception. Athletes with such predisposing factors are either suffering from unspecific anterior knee pain or from slightly traumatic or recurrent lateral patellar dislocation Treatment options of patellar instability are vast, and need to be tailored individually depending on the athlete's history, age, complaints and physical demands. Different conservative and surgical treatment options are reviewed and discussed, especially limited expectations after surgery.
    Orthopedic Reviews 07/2013; 5(3):e23. DOI:10.4081/or.2013.e23
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    • "In some cases the VMO is weak; however, many cases with adequate VMO strength still display delayed onset of the VMO when compared with the vastus lateralis [5] [20] [35] . "
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    ABSTRACT: Patellofemoral pain syndrome (PFPS) is a very common disorder of the knee. Due to multiple forces influencing the patellofemoral joint, clinical management of this ailment is particularly intricate. Patellofemoral pain syndrome has a multifactorial nature and multiple parameters have been proposed as potential risk factors, classified as intrinsic or extrinsic. Some of the intrinsic risk factors are modifiable and may be approached in treatment. A number of modifiable risk factors have been suggested, including quadriceps weakness, tightness of hamstring, iliopsoas and gastrosoleus muscles, hip muscles dysfunction, foot overpronation, tightness of iliotibial band, generalised joint laxity, limb length discrepancy, patellar malalignment and hypermobility. In general, the routine approach of physicians to this problem does not include assessment and modification of these risk factors and therefore, it may negatively affect the management outcomes. Changing this approach necessitates an easy and practical protocol for assessment of modifiable risk factors and effective and feasible measures to address them. In this review, we aimed to introduce assessment and intervention packages appropriate for this purpose.
    Asian Journal of Sports Medicine 06/2013; 4(2):85-100.
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