A Review of the Management of Patellofemoral Pain Syndrome

Abstract

A large number of athletes are impacted by PFPS every year, particularly young runners. Sports medicine researchers have investigated many possible therapies for patients with PFPS; however, no clear guidelines have emerged regarding the management of the syndrome. Our review analyzes recent literature on PFPS and identifies specific treatment recommendations. The most effective and strongly supported treatment modality for patients with PFPS is a combined physiotherapy program, including strength training of the quadriceps and hip abductors and stretching of the quadriceps muscle group. Adjunctive therapies, including taping, biofeedback devices, and prefabricated orthotic inserts, may provide limited additive benefits in select populations. Surgery should be avoided in all patients with PFPS.

Effects of strength training on the treatment of patellofemoral pain syndrome - a meta-analysis of randomized controlled trials

“…Despite the lack of meta-analyses on this subject, literature reviews on the issue corroborate the findings of the present study (16,27,28).…”

Medial release and lateral imbrication for intractable anterior knee pain: diagnostic process, technique, and results

“…Physiotherapy is the first-line option for beginning conservative treatment, and has been shown to be highly effective. 2 Unfortunately, in a small subset of patients, conservative management will fail, as it did in both of these patients. This leaves us with the predicament of what to do with the patient who has failed evidence-based, conservative treatment.…”

“…While there have been procedures used for the treatment of PFPS, previous research has shown that surgical techniques have been ineffective. 2 The surgeon responsible in these two cases was faced with two patients who had been suffering significant pain for a long time. These were both young patients who were limited in their activities by the pain, to the point that they were willing to go to great lengths for relief.…”

“…1 Previous research has shown surgical treatment of PFPS to be ineffective. 2 Two retrospective case reports (three surgical interventions) involving arthroscopic medial release and lateral imbrication of the patellar retinaculum (AMRLIPR) for intractable PFPS are presented in view of the novel nature of the procedure in the management of intractable PFPS. Intractable PFPS, for the purposes of this article, is defined as persistent (more than 6 months duration) PFPS that has failed to improve with conservative treatment.…”

Management and Outcomes of an Acute Mid Substance Medial Patella Femoral Ligament Repairs in Adolescents

“…This includes open communication between the orthopedist, the physical therapy team and the patient. Several investigators have identified a link between abnormal hip strength and patellofemoral pain [10][11][12]26,27]. Excessive hip adduction and internal rotation can cause a decrease in the contact area between the patella and trochlea and a subsequent increase in the lateral joint stress [28][29][30].…”