Patellofemoral Pain Syndrome (PFPS)
Basics
Basics
Basics
Description
Description
Description
- Pain in or around the patella that is aggravated with increased patellar loading (e.g., prolonged sitting, squatting, kneeling, or ascending/descending stairs); not attributable to other causes
- Synonyms: anterior knee or retropatellar pain syndrome, chondromalacia patellae, runner’s knee
- System(s) affected: musculoskeletal
Epidemiology
Epidemiology
Epidemiology
Prevalence
- Incidence between 2007 and 2011 in the United States was ~6%.
- 55% of patients were female.
- More cases were identified in the southern portion of the United States, compared to other regions of the country (1).
- In a military population, prevalence of 12% in males and 15% in females (2).
Etiology and Pathophysiology
Etiology and Pathophysiology
Etiology and Pathophysiology
Increased patellofemoral joint loading, which is often multifactorial (3):
- Patellar malalignment or maltracking (3)
- Abnormal anatomy (e.g., patella alta, trochlear dysplasia) (3)
- Quadriceps asymmetry, weakness and/or tightness (3)
- Hamstring tightness (3)
- Laxity of the patellofemoral joint or a tight lateral retinaculum (3)
- Increased hip joint internal rotation (3)
- Altered tibiofemoral joint mechanics (3)
Risk Factors
Risk Factors
Risk Factors
- Activities such as running, squatting, and climbing up and down stairs
- Sudden increase in activities
- Female gender
- Dynamic valgus
- Patellar instability
- Quadriceps weakness
- Foot abnormalities (e.g., pes pronatus, rearfoot eversion) (1)
- In adolescents: increased hip adduction strength, although this may represent increased activity level
- Factors of uncertain significance: age, height, weight, body mass index, body fat, Q angle, and hip weakness
General Prevention
General Prevention
General Prevention
Strengthening and stretching exercises, particularly hip abductors and terminal extension of the quadriceps
Commonly Associated Conditions
Commonly Associated Conditions
Commonly Associated Conditions
- Overuse injury
- Knee ligament injury/surgery
- Patellar tendinopathy
- Prolonged synovitis
- Iliotibial band friction syndrome
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