Medscape is available in 5 Language Editions – Choose your Edition here.


Patellofemoral Arthritis Medication

  • Author: Dinesh Patel, MD, FACS; Chief Editor: Thomas M DeBerardino, MD  more...
Updated: Mar 31, 2015

Medication Summary

Nonoperative measures for patellofemoral arthritis are primarily aimed at relieving pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to control inflammation.


Nonsteroidal Anti-Inflammatory Drugs

Class Summary

NSAIDs are useful in controlling inflammation. These agents are also useful in inflammatory arthritis. Some examples of commonly used NSAIDs include naproxen, ibuprofen, and diclofenac.

Naproxen (Anaprox, Naprelan, Naprosyn)


Naproxen is used for relief of mild to moderate pain. It inhibits inflammatory reactions and pain by decreasing cyclooxygenase activity, which decreases prostaglandin synthesis.

Ibuprofen (Advil, Motrin)


Ibuprofen is commonly used for the treatment of mild to moderately severe pain, if no contraindications exist. It inhibits inflammatory reactions and pain, probably by decreasing activity of cyclooxygenase, which decreases prostaglandin synthesis.

Diclofenac (Voltaren-XR, Cataflam, Zipsor)


Diclofenac is one of a series of phenylacetic acids that has demonstrated anti-inflammatory and analgesic properties in pharmacological studies. It is believed to inhibit the enzyme cyclooxygenase, which is essential in the biosynthesis of prostaglandins.

Contributor Information and Disclosures

Dinesh Patel, MD, FACS Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.


H Del Schutte, Jr, MD Associate Professor of Orthopedic Surgery, Department of Orthopedic Surgery, Medical University of South Carolina

H Del Schutte, Jr, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Association, California Medical Association, South Carolina Medical Association, Southern Medical Association, Southern Orthopaedic Association, Orthopaedic Research Society, American Association of Hip and Knee Surgeons

Disclosure: Nothing to disclose.

Kathleen A Hogan, MD Fellow in Arthroplasty, Department of Orthopedics, Brigham and Women's Hospital

Kathleen A Hogan, MD is a member of the following medical societies: Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Thomas M DeBerardino, MD Associate Professor, Department of Orthopedic Surgery, Consulting Surgeon, Sports Medicine, Arthroscopy and Reconstruction of the Knee, Hip and Shoulder, Team Physician, Orthopedic Consultant to UConn Department of Athletics, University of Connecticut Health Center

Thomas M DeBerardino, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Arthrex, Inc.; Ivy Sports Medicine; MTF; Aesculap; The Foundry, Cotera; ABMT<br/>Received research grant from: Histogenics; Cotera; Arthrex.

Additional Contributors

Charles T Mehlman, DO, MPH Professor of Pediatrics and Pediatric Orthopedic Surgery, Division of Pediatric Orthopedic Surgery, Director, Musculoskeletal Outcomes Research, Cincinnati Children's Hospital Medical Center

Charles T Mehlman, DO, MPH is a member of the following medical societies: American Academy of Pediatrics, American Fracture Association, Scoliosis Research Society, Pediatric Orthopaedic Society of North America, American Medical Association, American Orthopaedic Foot and Ankle Society, American Osteopathic Association, Arthroscopy Association of North America, North American Spine Society, Ohio State Medical Association

Disclosure: Nothing to disclose.

  1. Kelly MA, Insall JN. Historical perspectives of chondromalacia patellae. Orthop Clin North Am. 1992 Oct. 23(4):517-21. [Medline].

  2. Outerbridge RE. The etiology of chondromalacia patellae. 1961. Clin Orthop Relat Res. 2001 Aug. 5-8. [Medline].

  3. Grelsamer RP, Weinstein CH. Applied biomechanics of the patella. Clin Orthop Relat Res. 2001 Aug. 9-14. [Medline].

  4. Froimson MI, Ratcliffe A, Gardner TR, Mow VC. Differences in patellofemoral joint cartilage material properties and their significance to the etiology of cartilage surface fibrillation. Osteoarthritis Cartilage. 1997 Nov. 5(6):377-86. [Medline].

  5. Herberhold C, Stammberger T, Faber S, Putz R, Englmeier KH, Reiser M, et al. An MR-based technique for quantifying the deformation of articular cartilage during mechanical loading in an intact cadaver joint. Magn Reson Med. 1998 May. 39(5):843-50. [Medline].

  6. Herberhold C, Faber S, Stammberger T, Steinlechner M, Putz R, Englmeier KH, et al. In situ measurement of articular cartilage deformation in intact femoropatellar joints under static loading. J Biomech. 1999 Dec. 32(12):1287-95. [Medline].

  7. Mizuno Y, Kumagai M, Mattessich SM, Elias JJ, Ramrattan N, Cosgarea AJ, et al. Q-angle influences tibiofemoral and patellofemoral kinematics. J Orthop Res. 2001 Sep. 19(5):834-40. [Medline].

  8. Huberti HH, Hayes WC. Patellofemoral contact pressures. The influence of q-angle and tendofemoral contact. J Bone Joint Surg Am. 1984 Jun. 66(5):715-24. [Medline].

  9. Goodfellow J, Hungerford DS, Zindel M. Patello-femoral joint mechanics and pathology. 1. Functional anatomy of the patello-femoral joint. J Bone Joint Surg Br. 1976 Aug. 58(3):287-90. [Medline].

  10. Herzog W, Diet S, Suter E, Mayzus P, Leonard TR, Müller C, et al. Material and functional properties of articular cartilage and patellofemoral contact mechanics in an experimental model of osteoarthritis. J Biomech. 1998 Dec. 31(12):1137-45. [Medline].

  11. Järvelä T, Paakkala T, Kannus P, Järvinen M. The incidence of patellofemoral osteoarthritis and associated findings 7 years after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone autograft. Am J Sports Med. 2001 Jan-Feb. 29(1):18-24. [Medline].

  12. Boyd AD Jr, Ewald FC, Thomas WH, Poss R, Sledge CB. Long-term complications after total knee arthroplasty with or without resurfacing of the patella. J Bone Joint Surg Am. 1993 May. 75(5):674-81. [Medline].

  13. Kujala UM, Kettunen J, Paananen H, Aalto T, Battié MC, Impivaara O, et al. Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheum. 1995 Apr. 38(4):539-46. [Medline].

  14. Nagamine R, Miura H, Inoue Y, Tanaka K, Urabe K, Okamoto Y, et al. Malposition of the tibial tubercle during flexion in knees with patellofemoral arthritis. Skeletal Radiol. 1997 Oct. 26(10):597-601. [Medline].

  15. Johnson LL, van Dyk GE, Green JR 3rd, Pittsley AW, Bays B, Gully SM, et al. Clinical assessment of asymptomatic knees: comparison of men and women. Arthroscopy. 1998 May-Jun. 14(4):347-59. [Medline].

  16. Tanamas SK, Teichtahl AJ, Wluka AE, Wang Y, Davies-Tuck M, Urquhart DM, et al. The associations between indices of patellofemoral geometry and knee pain and patella cartilage volume: a cross-sectional study. BMC Musculoskelet Disord. 2010 May 10. 11:87. [Medline]. [Full Text].

  17. Merchant AC. Patellofemoral imaging. Clin Orthop Relat Res. 2001 Aug. 15-21. [Medline].

  18. von Engelhardt LV, Lahner M, Klussmann A, Bouillon B, Dàvid A, Haage P, et al. Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice. BMC Musculoskelet Disord. 2010 Apr 20. 11:75. [Medline]. [Full Text].

  19. Segal NA, Glass NA, Torner J, Yang M, Felson DT, Sharma L, et al. Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort. Osteoarthritis Cartilage. 2010 Jun. 18(6):769-75. [Medline]. [Full Text].

  20. Crossley KM, Marino GP, Macilquham MD, Schache AG, Hinman RS. Can patellar tape reduce the patellar malalignment and pain associated with patellofemoral osteoarthritis?. Arthritis Rheum. 2009 Dec 15. 61(12):1719-25. [Medline].

  21. Gigante A, Pasquinelli FM, Paladini P, Ulisse S, Greco F. The effects of patellar taping on patellofemoral incongruence. A computed tomography study. Am J Sports Med. 2001 Jan-Feb. 29(1):88-92. [Medline].

  22. Kannus P, Natri A, Paakkala T, Järvinen M. An outcome study of chronic patellofemoral pain syndrome. Seven-year follow-up of patients in a randomized, controlled trial. J Bone Joint Surg Am. 1999 Mar. 81(3):355-63. [Medline].

  23. Kirkley A, Birmingham TB, Litchfield RB, et al. A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine. Available at Accessed: September 11, 2008.

  24. Marx RG. Arthroscopic Surgery for Osteoarthritis of the Knee?. New England Journal of Medicine. Available at Accessed: September 11, 2008.

  25. Barclay L, Nghiem HT. Arthroscopic Surgery May Not Be Helpful for Knee Osteoarthritis. Medscape. Available at Accessed: September 11, 2008.

  26. Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med. 1994 Oct 6. 331(14):889-95. [Medline].

  27. Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003. 85-A Suppl 2:17-24. [Medline].

  28. Hangody L, Füles P. Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am. 2003. 85-A Suppl 2:25-32. [Medline].

  29. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003 Mar. 85(2):223-30. [Medline].

  30. Ghazavi MT, Pritzker KP, Davis AM, Gross AE. Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. J Bone Joint Surg Br. 1997 Nov. 79(6):1008-13. [Medline].

  31. Fitzpatrick PL, Morgan DA. Fresh osteochondral allografts: a 6-10-year review. Aust N Z J Surg. 1998 Aug. 68(8):573-9. [Medline].

  32. Chu CR, Convery FR, Akeson WH, Meyers M, Amiel D. Articular cartilage transplantation. Clinical results in the knee. Clin Orthop Relat Res. 1999 Mar. 159-68. [Medline].

  33. Shasha N, Krywulak S, Backstein D, Pressman A, Gross AE. Long-term follow-up of fresh tibial osteochondral allografts for failed tibial plateau fractures. J Bone Joint Surg Am. 2003. 85-A Suppl 2:33-9. [Medline].

  34. Gracitelli GC, Meric G, Pulido PA, Görtz S, De Young AJ, Bugbee WD. Fresh Osteochondral Allograft Transplantation for Isolated Patellar Cartilage Injury. Am J Sports Med. 2015 Jan 16. [Medline].

  35. Watkins MP, Harris BA, Wender S, Zarins B, Rowe CR. Effect of patellectomy on the function of the quadriceps and hamstrings. J Bone Joint Surg Am. 1983 Mar. 65(3):390-5. [Medline].

  36. Garr EL, Moskowitz RW, Davis W. Degenerative changes following experimental patellectomy in the rabbit. Clin Orthop Relat Res. 1973 May. 296-304. [Medline].

  37. Ackroyd CE, Polyzoides AJ. Patellectomy for osteoarthritis. A study of eighty-one patients followed from two to twenty-two years. J Bone Joint Surg Br. 1978 Aug. 60-B(3):353-7. [Medline].

  38. Feller JA, Bartlett RJ. Patellectomy and osteoarthritis: arthroscopic findings following previous patellectomy. Knee Surg Sports Traumatol Arthrosc. 1993. 1(3-4):159-61. [Medline].

  39. Joshi AB, Lee CM, Markovic L, Murphy JC, Hardinge K. Total knee arthroplasty after patellectomy. J Bone Joint Surg Br. 1994 Nov. 76(6):926-9. [Medline].

  40. Paletta GA Jr, Laskin RS. Total knee arthroplasty after a previous patellectomy. J Bone Joint Surg Am. 1995 Nov. 77(11):1708-12. [Medline].

  41. Kolettis GT, Stern SH. Patellar resurfacing for patellofemoral arthritis. Orthop Clin North Am. 1992 Oct. 23(4):665-73. [Medline].

  42. van Jonbergen HP, Werkman DM, Barnaart LF, van Kampen A. Long-term outcomes of patellofemoral arthroplasty. J Arthroplasty. 2010 Oct. 25(7):1066-71. [Medline].

  43. Petrie RS, Hanssen AD, Osmon DR, Ilstrup D. Metal-backed patellar component failure in total knee arthroplasty: a possible risk for late infection. Am J Orthop (Belle Mead NJ). 1998 Mar. 27(3):172-6. [Medline].

  44. Krajca-Radcliffe JB, Coker TP. Patellofemoral arthroplasty. A 2- to 18-year followup study. Clin Orthop Relat Res. 1996 Sep. 143-51. [Medline].

  45. Cartier P, Sanouiller JL, Grelsamer R. Patellofemoral arthroplasty. 2-12-year follow-up study. J Arthroplasty. 1990 Mar. 5(1):49-55. [Medline].

  46. Argenson JN, Guillaume JM, Aubaniac JM. Is there a place for patellofemoral arthroplasty?. Clin Orthop Relat Res. 1995 Dec. 162-7. [Medline].

  47. Lonner JH. Patellofemoral arthroplasty: the impact of design on outcomes. Orthop Clin North Am. 2008 Jul. 39(3):347-54, vi. [Medline].

  48. Laskin RS, van Steijn M. Total knee replacement for patients with patellofemoral arthritis. Clin Orthop Relat Res. 1999 Oct. 89-95. [Medline].

  49. Healy WL, Wasilewski SA, Takei R, Oberlander M. Patellofemoral complications following total knee arthroplasty. Correlation with implant design and patient risk factors. J Arthroplasty. 1995 Apr. 10(2):197-201. [Medline].

  50. Ikejiani CE, Leighton R, Petrie DP. Comparison of patellar resurfacing versus nonresurfacing in total knee arthroplasty. Can J Surg. 2000 Feb. 43(1):35-8. [Medline].

  51. Kim BS, Reitman RD, Schai PA, Scott RD. Selective patellar nonresurfacing in total knee arthroplasty. 10 year results. Clin Orthop Relat Res. 1999 Oct. 81-8. [Medline].

  52. Pollo FE, Jackson RW, Koëter S, Ansari S, Motley GS, Rathjen KW. Walking, chair rising, and stair climbing after total knee arthroplasty: patellar resurfacing versus nonresurfacing. Am J Knee Surg. 2000 Spring. 13(2):103-8; discussion 108-9. [Medline].

  53. Smith AJ, Wood DJ, Li MG. Total knee replacement with and without patellar resurfacing: a prospective, randomised trial using the profix total knee system. J Bone Joint Surg Br. 2008 Jan. 90(1):43-9. [Medline].

  54. Tanzer M, McLean CA, Laxer E, Casey J, Ahmed AM. Effect of femoral component designs on the contact and tracking characteristics of the unresurfaced patella in total knee arthroplasty. Can J Surg. 2001 Apr. 44(2):127-33. [Medline].

  55. Schroeder-Boersch H, Scheller G, Fischer J, Jani L. Advantages of patellar resurfacing in total knee arthroplasty. Two-year results of a prospective randomized study. Arch Orthop Trauma Surg. 1998. 117(1-2):73-8. [Medline].

  56. Kawakubo M, Matsumoto H, Otani T, Fujikawa K. Radiographic changes in the patella after total knee arthroplasty without resurfacing the patella. Comparison of osteoarthrosis and rheumatoid arthritis. Bull Hosp Jt Dis. 1997. 56(4):237-44. [Medline].

  57. López-Franco M, Murciano-Antón MA, Fernández-Aceñero MJ, De Lucas-Villarrubia JC, López-Martín N, Gómez-Barrena E. Evaluation of a minimally aggressive method of patellofemoral osteoarthritis treatment at 10 years minimum follow-up. Knee. 2013 Dec. 20(6):476-81. [Medline].

  58. Culvenor AG, Lai CC, Gabbe BJ, Makdissi M, Collins NJ, Vicenzino B, et al. Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction. Br J Sports Med. 2014 Mar. 48(6):435-9. [Medline].

Patellofemoral arthritis. The sulcus angle is the angle formed by the condyles and the sulcus. This is a measurement of trochlear depth. A finding greater than 138° indicates the presence of patellofemoral dysplasia.
Patellofemoral arthritis. The patellofemoral index is the ratio of M, the closest distance between the articular ridge and the medial condyle, and L, the closest distance between the lateral facet and condyle.
Patellofemoral arthritis. The lateral patellofemoral angle is the angle between the intercondylar line and the lateral facet.
Patellofemoral arthritis. The Insall-Salvati ratio is used to assess the position of the patella and determine if the patella alta or patella baja is present. The ratio of the height of the patella to the length of the patella tendon should be 1:1.
Patellofemoral arthritis. Anteroposterior, lateral, and patellar views of an arthritic knee demonstrate severe patellofemoral arthritis. This patient subsequently underwent total knee arthroplasty.
Patellofemoral arthritis. Poor bone quality of the patella made a patella resurfacing procedure impossible in this patient who underwent total knee arthroscopy for severe arthritis.
Patellofemoral arthritis. This patient had severe medial compartment arthritis but a relatively normal patellofemoral joint. Therefore, patellofemoral resurfacing was not performed at the time of surgery.
Patellofemoral arthritis.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.