Patellofemoral Pain Syndrome
| Patellofemoral Pain Syndrome | |
|---|---|
| Synonym | Runner's knee, retropatellar pain syndrome, lateral facet compression syndrome, idiopathic anterior knee pain. Also chondromalacia patella where there are changes to the patella articular cartilage. |
| Definition | Anterior knee pain where other causes have been excluded. |
| Epidemiology | Very common. More common in women. |
Patellofemoral pain is anterior knee pain involving the patella and retinaculum where other causes of anterior knee pain have been excluded.
Clinical Features
- Fracture or tendon and ligament rupture, osteonecrosis: Major trauma, Sudden onset of pain, Minor trauma with risk factors (age over 50, history of osteoporosis, corticosteroid use)
- Infection, crystal arthritis: fever, night sweats, signs of inflammation, risk factors for infection (underlying disease process, immunosuppression, penetrating wound)
- Tumour: past history of malignancy, age >50, failure to improve, weight loss, pain at multiple sites, rest pain, night pain
Treatment
Acute Phase
In the acute phase overload is very likely. Runners should reduce their running volume, and in severe cases should stop running entirely. Those with more mild symptoms may only need to reduce more strenuous activities such as hill running. In order to maintain fitness runners can be encouraged to use a stationary bike, upper body cycle, swimming, or other activities that do not cause knee pain.
There is limited evidence for the use of NSAIDs in the short term, with naproxen being more effective than placebo.[1]
There is no evidence to support the use of ultrasound, iontophoresis, phonophoresis, or electrical stimulation.[1][2][3][4][5]
Resources
- ↑ 1.0 1.1 Heintjes et al.. Pharmacotherapy for patellofemoral pain syndrome. The Cochrane database of systematic reviews 2004. CD003470. PMID: 15266488. DOI. Full Text.
- ↑ Martimbianco et al.. Neuromuscular electrical stimulation (NMES) for patellofemoral pain syndrome. The Cochrane database of systematic reviews 2017. 12:CD011289. PMID: 29231243. DOI. Full Text.
- ↑ Shanks et al.. The effectiveness of therapeutic ultrasound for musculoskeletal conditions of the lower limb: A literature review. Foot (Edinburgh, Scotland) 2010. 20:133-9. PMID: 20961748. DOI.
- ↑ Bolin. Transdermal approaches to pain in sports injury management. Current sports medicine reports 2003. 2:303-9. PMID: 14583158. DOI.
- ↑ van der Windt et al.. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain 1999. 81:257-271. PMID: 10431713. DOI.
Literature Review
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
