Patella malalignment syndrome: rationale to reduce excessive lateral pressure

Patella malalignment syndrome is characterized by pain in the anterior portion of the knee. There can be numerous causes; however, the end result appears to be excessive lateral pressure on the patellofemoral articulation. This problem commonly affects athletes as an overuse injury. Standard conservative treatment attempts to decrease inflammation and increase strength whereas surgical techniques seek to correct the actual cause of the malalignment. The biomechanical approach advocated in this article employs the standard conservative treatments in addition to a passive forced technique designed to reduce lateral pressure by stretching the lateral retinaculum and patella compression to facilitate cartilage metabolism. The approach has proven effective in reducing symtoms and allowing early return to activity. J Orthop Sports Phys Ther 1986;8(6):301-309.