What are the symptoms of patellofemoral pain syndrome?
A common complaint of patellofemoral pain syndrome is knee pain that worsens with physical activity. Patients often describe a diffuse and dull pain in their knee that worsened gradually with time. Pain after sitting with the knees bent for a prolonged amount of time has also been reported. Some individuals also report a “crackling” or “popping” sound with knee movement after sitting for an extended period of time.
How is patellofemoral pain syndrome diagnosed?
Dr. Patel will obtain an extensive medical history, including physical activity habits, followed by a thorough physical examination of the knee joint. Patellofemoral pain syndrome is commonly diagnosed with a physical examination and medical history; however, diagnostic imaging tools such as x-rays and magnetic resonance imaging (MRI) may be requested to rule out damage to any other structures within the knee joint.
What is the treatment for patellofemoral pain syndrome?
Non-operative therapies are often successful for most patients with a confirmed patellofemoral pain syndrome diagnosis. The pain and inflammation associated with this condition can be managed with a combination of RICE (rest, ice, compression, elevation) and non-steroidal anti-inflammatory medications (NSAIDs). Custom-made shoe insoles and taping the patella may be considered to help alleviate knee pain. Dr. Patel will recommend a physical rehabilitation program with a patellofemoral focus.
Patellofemoral pain syndrome is rarely treated with surgical measures as the majority of patients are able to find relief with non-operative treatments. However, patients that continue to experience severe knee pain after a trial of conservative therapies may benefit from surgical intervention if structural problems are identified on MRI. A small camera (arthroscope) and specialized surgical instruments are used in a minimally invasive surgical procedure to identify the cause of knee pain. Dr. Patel will then implement one, or more, of the following procedures:
- The areas of tissue damage are excised and removed. Removal of any other abnormalities, such as loose bodies, inflamed tissues, or bone spurs, is also performed.
- Lateral Retinaculum Release. A fibrous tissue on the outer patella, known as the lateral retinaculum, is released as a common surgical technique for patellar instability. Releasing the lateral retinaculum can alleviate tension along the outer knee and help reposition the patella.
- Cartilage Transplant Surgery. If a cartilage defect is identified, this may be treated with cartilage restoration.
- Tibial Tubercle Osteotomy. This procedure is reserved for patients that experience patellar malalignment due to a shallow trochlear groove, patellar instability, or cartilage defects. This open surgical technique transfers the tibial tubercle (bony prominence of the shin bone), with the patellar tendon still attached, to another position on the tibia.