Patellofemoral Pain Syndrome (PFPS)
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Basics
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
Prevalence
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
- 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
- Previously considered risk factors, now of uncertain significance: 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
- Iliotibial band friction syndrome
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
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
Prevalence
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
- 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
- Previously considered risk factors, now of uncertain significance: 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
- Iliotibial band friction syndrome
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