Patellofemoral Pain Syndrome

This is a pain you feel in the front of your knee. It involves the Patella. That's the bone we commonly call the "kneecap."

What is it?

This is a pain you feel in the front of your knee. It involves the patella. That's the bone we commonly call the "kneecap." The patella slides up and down in a groove on your femur as you bend and extend your knee. If you have this syndrome, you may have injured the soft tissues that support and cushion your kneecap. Or, you may have some damage to the cartilage on the underside of the kneecap. 

What causes it?

You can develop this syndrome if you repeatedly stress your knees. This can happen if you do a lot of physical activity that involves running, squatting or climbing stairs. It can develop if you use poor training techniques or equipment. You can develop it if you change your exercise routine, change your shoes or change the surface you play on. This condition can also result from the problems with your anatomy. For example, you may have alignment problems with your legs or kneecaps, or you may have a muscle imbalance that affects your knees. 

signs and symptoms

This syndrome can cause pain under and around one or both kneecaps. Its a dull aching sensation. You may feel it more during activity and also after you sit with your knees bent for a long time. And, you may hear popping and cracking sounds in your knee. 

non-surgical treatment

Patellofemoral pain syndrome can often be treated with rest, ice, compression and elevation. You may benefit from medications and orthotics. 

surgical treatment

If these aren't helpful, you may benefit from surgery. Your healthcare provider can create a plan that's right for you. 

Patellar Kneecap Dislocation

The patella, known as the kneecap, makes up the anterior (front) portion of the knee joint. The tendon of the quadriceps (thigh muscle) attaches to the top of the patella, and the patellar tendon attaches to the base of the patella and connects it to the tibia (shin bone). Patellofemoral injuries are a broad range of injuries that cause pain in the front of the knee around the patella. Atraumatic pain over the front of the knee related to overuse is called patellofemoral syndrome, also known as “runner’s knee” because they are often related to overuse and repetitive loading on the patellofemoral joint (activities like running and jumping). Patellofemoral pain is exacerbated after sitting or prolonged knee flexion and is frequently painful with stairs. Nonoperative treatment options resolve the vast majority of patients with patellofemoral syndrome, and are initially recommended to reduce pain and return to normal level of activity. These treatments include physical therapy, activity modification, oral anti-inflammatory medications (NSAIDs), bracing and occasionally steroid injections. Rarely arthroscopic surgery is recommended to relieve pain.

Patellofemoral pain and instability can also result from the patella dislocating from its original position in the joint. This commonly occurs with abrupt twisting or direct trauma. Dislocating the patella leads to sharp pain in the kneecap and if the kneecap does not go back in place on its own, it must be reduced (retuned back to its normal position). Following a patellar dislocation, instability (feelings of the kneecap giving out or re-dislocating) can become recurrent. The majority of primary (first time) patellar dislocations improve with nonoperative treatment, inclusive of activity modification, proper physical therapy, a stabilization brace, and anti-inflammatory medication. In cases of recurrent (more than once) patellar instability, surgical treatment is often recommended to reconstruct the soft tissues or bony problems leading to recurrent patellar instability. Identifying the main cause of patellar instability is important help determine the best surgical solution which can range from a knee arthroscopy and isolated ligament reconstruction to a combined reconstruction and bony realignment procedure.

At The Knee Center at Andrews Sports Medicine, our fellowship-trained non-surgical physicians and orthopaedic surgeons provide the most-advanced, comprehensive treatment solutions for injuries and disorders of the knee. To schedule an appointment, call (205) 939-3699.

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