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.

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)

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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)

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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)

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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.

Questions

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Media Gallery

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.

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Author

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.

Coauthor(s)

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, The Scientific Research Honor Society

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.

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, FAAOS, FAOA Professor of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, Joe R and Teresa Lozano Long School of Medicine; Professor of Orthopaedic Surgery and Faculty of Sports Medicine Fellowship, Baylor College of Medicine; Sports Medicine Orthopaedic Surgeon, Department of Orthopaedics, UT Health San Antonio; Consulting Surgeon, Sports Medicine, Arthroscopy and Reconstruction of the Knee, Hip and Shoulder

Thomas M DeBerardino, MD, FAAOS, FAOA is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, Clinical Orthopaedic Society, Herodicus Society, International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Arthrex, Inc.; MTF; Aesculap; Conmed; JRF<br/>Received research grant from: Arthrex, Inc.; MTF.

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.