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Patellofemoral Pain

The Kneecap (patella) forms part of the patellofemoral compartment of the knee.

The patella is a relatively small, mobile bone which is subject to large forces in everyday activity such as arising from a chair and climbing or descending steps/ stairs. Kneecap (patellofemoral) pain is the most common knee problem. Patellofemoral pain affects a wide age range from early adolescence to older age. Unfortunately, the cause of the pain is often uncertain and therefore it is difficult too treat or 'cure'.

Kneecap (patellofemoral) pain is the commonest knee problem.

Typical symptoms include:

  • Pain with bending, kneeling and climbing
  • Stiffness and pain after prolonged sitting/ driving
  • A sensation of catching/ locking/ grating
  • Vague aching with weather change
  • A feeling of instability

The pain is often poorly localised but is usually felt around the front of the knee or under the kneecap but also commonly in the back of the knee.

The most common contributing factors are:

Abnormal or increased load

  • Repetitive bending, squatting, climbing, kneeling or heavy lifting
  • Gaining weight

Abnormal tracking/ alignment of the kneecap

  • In most cases this is subtle but in extreme cases the kneecap may come out of its groove (dislocate)
  • If significant this may be amenable to surgical treatment

Investigations including x-rays and MRI scans are often normal.

The majority of cases are associated with abnormal or increased load or subtle maltracking of the kneecap.

Surgery has very little role in these patients and treatment is directed at decreasing the loads on the kneecap by:

  • Weight loss
  • Avoiding/ minimising bending, squatting etc.
  • Improving kneecap tracking by:
    • Stretches
    • Taping
    • Kneecap brace/ strap
    • Orthotics

Surgery (arthroscopy) has a role in:

  • Later stages where there is significant pain, swelling, grating, catching or locking
  • Significant kneecap mal tracking

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