Patellofemoral pain syndrome

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanical Analysis

Background:

• Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain, particularly in young females.
• PFPS often occurs without significant structural abnormalities like increased Q-angle or chondral damage.
• It is increasingly recognized as multifactorial, involving functional disorders of the lower extremity.

Purpose of the Study:

• To review the literature on the multifactorial causes of patellofemoral pain syndrome.
• To evaluate current non-operative treatment strategies for PFPS.
• To emphasize the importance of identifying and addressing functional deficits in PFPS management.

Main Methods:

• Literature review of biomechanical studies and clinical trials.
• Analysis of factors contributing to patellar maltracking and dynamic valgus.
• Evaluation of evidence for non-operative therapeutic interventions.

Main Results:

• PFPS is associated with functional malalignment, including patellar maltracking and dynamic valgus, often due to hip abductor weakness or pes pronatus.
• Muscle imbalances (vastus medialis/lateralis), hamstring tightness, and iliotibial tract tightness are linked to PFPS.
• Multimodal non-operative therapy, including NSAIDs, taping, and comprehensive exercise programs, shows evidence of efficacy.
• Patellar braces and foot orthotics may also be beneficial.

Conclusions:

• PFPS is primarily driven by functional deficits rather than structural changes.
• Non-operative management focusing on addressing biomechanical and functional causes is the recommended approach.
• Arthroscopy is not indicated for PFPS lacking structural abnormalities.