Patellofemoral Syndrome

"Surgical treatment for patellofemoral pain is rarely necessary and is performed only in severe cases that do not respond to non-surgical treatment".

DR. ANDRÉS VALENTÍ AZCÁRATE
SPECIALIST. ORTHOPEDIC SURGERY AND TRAUMATOLOGY DEPARTMENT

Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the kneecap. 
The age range of onset of the discomfort is very varied.

Sometimes, it occurs in athletes and appears in the form of "patellar tendinopathy" and other times it appears more frequently in young or middle-aged women.

The pain and stiffness it causes can make it difficult to climb stairs, kneel and perform other daily activities.

Problems with the alignment of the kneecap, muscle insufficiency, excessive or inadequate training, among others, are factors that can cause the onset of pain.

Symptoms are often relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program.

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What are the symptoms of patellofemoral syndrome?

The most common symptom of patellofemoral pain syndrome is a dull and more or less painful pain in the front of the knee. This pain, which usually begins gradually and is often related to activity, may be present in one or both knees.

Other common symptoms include

Joint crackling, discomfort or a feeling of knee locking in stairs or when getting up after sitting for a long time.

Some patients report burning sensations, discomfort or simple nighttime discomfort.

The most common symptoms are:

  • Dull pain in the anterior part of the knee.
  • Cracks in the knee.
  • Sensation of cramping.

Do you have any of these symptoms?

You may suffer from patellofemoral syndrome

What are the causes of patellofemoral syndrome?

The main reason for the appearance of the discomfort corresponds to an overload and stimulation of the sensitive ends around the kneecap. There are various causes: 

  • Excessive use of the knee: In many cases, it is caused by vigorous physical activities that put repeated pressure on the knee, such as running, squatting and climbing stairs. It can also be caused by a sudden change in physical activity either in frequency, intensity, duration or technique. 
  • Patellar misalignment or misalignment of the limb causes the kneecap to not work properly, resulting in hyperpressure and mechanical changes that condition pain.
  • Muscle imbalance or insufficiency, especially in quadriceps, gluteus and hamstrings.
  • Other factors that can contribute to patellofemoral pain include changes in footwear or playing surfaces.

How is patellofemoral syndrome treated?

In most cases, patellofemoral pain can be treated without surgery.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help reduce swelling and provide temporary pain relief. Chondroprotective" drugs such as chondroitin sulfate and glycosaminoglycans help relieve mild nonspecific symptoms, although treatment should be prolonged as they do not provide immediate relief.

In addition to changes in activity and medications in a timely manner, rehabilitative or physiotherapeutic treatment is recommended. Exercises are the basic pillar for correcting or alleviating the cause.

It is essential to maintain proper conditioning of the muscles around the knee and pelvic control, particularly the quadriceps, gluteus medius and hamstrings.

Hyaluronic acid infiltrations or platelet growth factors may be indicated for the relief of discomfort.

The knee braces can help at the time of sporting activity to reduce the overload. The use of insoles can be indicated to correct alterations in the footprint or the load axis. 

Surgical treatment for patellofemoral pain is rarely necessary and is performed only in severe cases that do not respond to non-surgical treatment. Surgical treatments are usually performed by arthroscopy.

En muchos casos, el dolor patelofemoral mejorará con un tratamiento simple en el hogar. El reposo y hielo puede aliviar las molestias puntualmente.

Cambios o regulación de actividad: Limite las actividades que hacen que le duela la rodilla hasta que se resuelva su dolor. Esto puede significar cambiar su rutina de entrenamiento o cambiar a actividades de bajo impacto.

Deportes de bajo impacto como bicicleta, elíptica y nadar son buenas opciones. Si tiene sobrepeso, perder peso también ayudará a reducir la presión sobre su rodilla.

Ejercicios de tonificación muscular y propiocepción: cuádriceps, glúteo medio y musculatura de control de cadera junto con estiramiento de isquiotibiales.

Where do we treat it?

IN NAVARRA AND MADRID

The Department of Orthopedic Surgery and Traumatology
of the Clínica Universidad de Navarra

The Department of Orthopedic Surgery and Traumatology covers the full spectrum of congenital or acquired conditions of the musculoskeletal system including trauma and its aftermath.

Since 1986, the Clinica Universidad de Navarra has had an excellent bank of osteotendinous tissue for bone grafting and offers the best therapeutic alternatives.

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  • Pediatric orthopedics.
  • Ankle and foot.
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