Patellofemoral Pain Syndrome (PFPS)

Patellofemoral Pain Syndrome (PFPS) is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Pain in or around the patella that increases with increased patellar loading (prolonged sitting, squatting, kneeling, or ascending/descending stairs); not attributable to other causes
  • Synonyms: anterior knee or retropatellar pain syndrome, chondromalacia patella, runner’s knee
  • System(s) affected: musculoskeletal

Epidemiology

Prevalence
  • Annual prevalence of 29% in adolescents and 23% in adults (1)
  • In a military population, prevalence of 12% in males and 15% in females (2)

Etiology and Pathophysiology

Increased patellofemoral joint loading, which is often multifactorial: (3)

  • Patellar misalignment or maltracking (3)
  • Abnormal anatomy (e.g., patella alta, trochlear dysplasia) (3)
  • Quadriceps 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)

Risk Factors

  • In a military population: quadriceps weakness
  • In adolescents: increased hip adduction strength, although this may represent increased activity level
  • Previously considered risk factors: age, height, weight, body mass index, body fat, Q angle, and hip weakness

General Prevention

Strengthening and stretching exercises, particularly hip abductors and terminal extension of the quadriceps

Commonly Associated Conditions

  • Overuse
  • Knee ligament injury/surgery
  • Patellar tendinopathy
  • Prolonged synovitis
  • IT band friction syndrome

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Basics

Description

  • Pain in or around the patella that increases with increased patellar loading (prolonged sitting, squatting, kneeling, or ascending/descending stairs); not attributable to other causes
  • Synonyms: anterior knee or retropatellar pain syndrome, chondromalacia patella, runner’s knee
  • System(s) affected: musculoskeletal

Epidemiology

Prevalence
  • Annual prevalence of 29% in adolescents and 23% in adults (1)
  • In a military population, prevalence of 12% in males and 15% in females (2)

Etiology and Pathophysiology

Increased patellofemoral joint loading, which is often multifactorial: (3)

  • Patellar misalignment or maltracking (3)
  • Abnormal anatomy (e.g., patella alta, trochlear dysplasia) (3)
  • Quadriceps 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)

Risk Factors

  • In a military population: quadriceps weakness
  • In adolescents: increased hip adduction strength, although this may represent increased activity level
  • Previously considered risk factors: age, height, weight, body mass index, body fat, Q angle, and hip weakness

General Prevention

Strengthening and stretching exercises, particularly hip abductors and terminal extension of the quadriceps

Commonly Associated Conditions

  • Overuse
  • Knee ligament injury/surgery
  • Patellar tendinopathy
  • Prolonged synovitis
  • IT band friction syndrome

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