Patellofemoral Syndrome Follow-up

  • Author: Patrick J Potter, MD, FRCP(C); Chief Editor: Consuelo T Lorenzo, MD   more...
 
Updated: Feb 16, 2012
 

Further Inpatient Care

  • The standard procedure for treatment of individuals with patellofemoral syndrome is performed on an outpatient basis. Inpatient care generally is not indicated.
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Further Outpatient Care

  • Allow time for conservative measures (eg, exercise) to have a therapeutic effect in patients with patellofemoral syndrome. A period of 4-6 weeks usually is adequate for some resolution of symptoms. Longer delays before follow-up often result in reduced compliance with treatment recommendations. Reinforcement of treatment goals and strategies is important.
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Inpatient & Outpatient Medications

  • Outpatient medications for individuals with patellofemoral syndrome include common analgesics or NSAIDs (see Medication). Most individuals manage without medication once initial symptoms have been controlled.
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Deterrence

  • Prevention of patellofemoral syndrome (PFS) is accomplished by following exercise recommendations and making changes in activity, as described in previous sections. In female athletes, decreased hamstring-to-quadriceps strength ratios have been associated with an increased prevalence of overuse injuries, suggesting that maintaining adequate hamstring strength may act as a preventative strategy. Braces have been tried on asymptomatic subjects undergoing rigorous basic military training, with a subsequent decrease in the incidence of PFS compared with the subject population that did not use the braces.
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Complications

  • Complications in patients with patellofemoral syndrome may result secondary to the effects of NSAID use. Occasional dermatologic reactions occur due to the brace material. Prescribed exercises rarely result in aggravation of symptoms. If a specific activity is determined to be associated with aggravation of symptoms, then accordingly modify the frequency, duration, and intensity of the activity
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Prognosis

  • The prognosis for full functional recovery in cases of patellofemoral syndrome is very good. In general, this syndrome is successfully treated with conservative measures. Because the prognosis is so good, refractory cases should be closely reviewed with regard to compliance and understanding of treatment recommendations.
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Patient Education

  • Educate the patient so that he/she understands which activities aggravate patellofemoral syndrome. In addition, emphasize the need for extended adherence to the exercise regimen. The patient's physical therapist should educate the patient about a home exercise program, making sure the patient has a good understanding of the exercises.
  • For patient education resources, see the Foot, Ankle, Knee, and Hip Center, Arthritis Center, and Osteoporosis and Bone Health Center, as well as Knee Pain.
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Contributor Information and Disclosures
Author

Patrick J Potter, MD, FRCP(C)  Associate Professor, Department of Physical Medicine and Rehabilitation, University of Western Ontario School of Medicine; Consulting Staff, Department of Physical Medicine and Rehabilitation, St Joseph's Health Care Centre

Patrick J Potter, MD, FRCP(C) is a member of the following medical societies: American Paraplegia Society, Canadian Association of Physical Medicine and Rehabilitation, Canadian Medical Association, College of Physicians and Surgeons of Ontario, Ontario Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Coauthor(s)

Keith Aj Sequeira  MD, FRCPC, Associate Professor, Director of Education, Department of Physical Medicine and Rehabilitation, Parkwood Hospistal, University of Western Ontario

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM  President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, and Texas Medical Association

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

Patrick M Foye, MD  Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD  Physiatrist, Department of Physical Medicine and Rehabilitation, Alegent Health Immanuel Rehabilitation Center

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

References

  1. Piva SR, Fitzgerald GK, Irrgang JJ, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil. Feb 2009;90(2):285-95. [Medline].

  2. Price JL. Patellofemoral syndrome: how to perform a basic knee evaluation. JAAPA. Dec 2008;21(12):39-43. [Medline].

  3. Finnoff JT, Hall MM, Kyle K, Krause DA, Lai J, Smith J. Hip strength and knee pain in high school runners: a prospective study. PM R. Sep 2011;3(9):792-801. [Medline].

  4. Kettunen JA, Visuri T, Harilainen A, et al. Primary cartilage lesions and outcome among subjects with patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. Mar 2005;13(2):131-4. [Medline].

  5. Näslund JE, Odenbring S, Näslund UB, Lundeberg T. Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome. Br J Sports Med. Mar 2005;39(3):162-5. [Medline]. [Full Text].

  6. Schutzer SF, Ramsby GR, Fulkerson JP. Computed tomographic classification of patellofemoral pain patients. Orthop Clin North Am. Apr 1986;17(2):235-48. [Medline].

  7. Bolgla LA, Malone TR, Umberger BR, et al. Reliability of electromyographic methods used for assessing hip and knee neuromuscular activity in females diagnosed with patellofemoral pain syndrome. J Electromyogr Kinesiol. Jan 2 2009;[Medline].

  8. [Best Evidence] Syme G, Rowe P, Martin D, et al. Disability in patients with chronic patellofemoral pain syndrome: a randomised controlled trial of VMO selective training versus general quadriceps strengthening. Man Ther. Jun 2009;14(3):252-63. [Medline].

  9. Chiu JK, Wong YM, Yung PS, Ng GY. The effects of quadriceps strengthening on pain, function, and patellofemoral joint contact area in persons with patellofemoral pain. Am J Phys Med Rehabil. Feb 2012;91(2):98-106. [Medline].

  10. Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ. Oct 24 2008;337:a1735. [Medline]. [Full Text].

  11. Barton CJ, Menz HB, Crossley KM. Clinical Predictors of Foot Orthoses Efficacy in Individuals with Patellofemoral Pain. Med Sci Sports Exerc. Feb 8 2011;[Medline].

  12. Teitge RA. Patellofemoral syndrome a paradigm for current surgical strategies. Orthop Clin North Am. Jul 2008;39(3):287-311, v. [Medline].

  13. Crossley K, Bennell K, Green S, et al. A systematic review of physical interventions for patellofemoral pain syndrome. Clin J Sport Med. Apr 2001;11(2):103-10. [Medline].

  14. Devan MR, Pescatello LS, Faghri P, Anderson J. A Prospective Study of Overuse Knee Injuries Among Female Athletes With Muscle Imbalances and Structural Abnormalities. J Athl Train. Sep 2004;39(3):263-267. [Medline]. [Full Text].

  15. Handelberg F, Shahabpour M, Van Betten F, et al. CT arthrography and MRI of the patella. Acta Orthop Belg. 1989;55(3):331-8. [Medline].

  16. Haut RC, Ide TM, De Camp CE. Mechanical responses of the rabbit patello-femoral joint to blunt impact. J Biomech Eng. Nov 1995;117(4):402-8. [Medline].

  17. Hope PG. Arthroscopy in children. J R Soc Med. Jan 1991;84(1):29-31. [Medline]. [Full Text].

  18. Imai N, Tomatsu T, Nakaseko J, et al. Clinical and roentgenological studies on malalignment disorders of the patello-femoral joint. Part II: relationship between predisposing factors and malalignment of the patello-femoral joint. Nippon Seikeigeka Gakkai Zasshi. Nov 1987;61(11):1191-202. [Medline].

  19. Johnston LB, Gross MT. Effects of foot orthoses on quality of life for individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther. Aug 2004;34(8):440-8. [Medline].

  20. Juhn MS. Patellofemoral pain syndrome: a review and guidelines for treatment [published erratum appears in Am Fam Physician 2000 Feb 15;61(4):960, 965]. Am Fam Physician. Nov 1 1999;60(7):2012-22. [Medline]. [Full Text].

  21. Karlsson J, Sward L, Lansinger O. Bad results after anterior advancement of the tibial tubercle for patello-femoral pain syndrome. Arch Orthop Trauma Surg. 1992;111(4):195-7. [Medline].

  22. Karlsson J, Thomee R, Sward L. Eleven year follow-up of patello-femoral pain syndrome. Clin J Sport Med. Jan 1996;6(1):22-6. [Medline].

  23. Kujala UM, Friberg O, Aalto T, et al. Lower limb asymmetry and patellofemoral joint incongruence in the etiology of knee exertion injuries in athletes. Int J Sports Med. Jun 1987;8(3):214-20. [Medline].

  24. Martens M, De Rycke J. Facetectomy of the patella in patellofemoral osteoarthritis. Acta Orthop Belg. 1990;56(3-4):563-7. [Medline].

  25. Scott SH, Winter DA. Internal forces of chronic running injury sites. Med Sci Sports Exerc. Jun 1990;22(3):357-69. [Medline].

  26. Thomee R, Augustsson J, Karlsson J. Patellofemoral pain syndrome: a review of current issues. Sports Med. Oct 1999;28(4):245-62. [Medline].

  27. Wagenhauser FJ. [Clinical aspects of arthroses]. Verh Dtsch Ges Inn Med. 1989;95:449-62. [Medline].

 
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