Patellofemoral Joint Syndromes Follow-up

Updated: Oct 21, 2015
  • Author: Jane T Servi, MD; Chief Editor: Craig C Young, MD  more...
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Follow-up

Return to Play

Return to play or previous activity may be resumed when 80% of the strength of the uninjured knee (as measured by isokinetic testing) has been reached in the affected knee. If there has not been a significant loss of strength, the athlete may continue to play as symptoms allow. For those with loss of strength, continued play predisposes to injury secondary to guarding by the athlete.

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Prevention

Prevention consists of correcting biomechanical imbalances. [28] The patient should wear arch supports or orthotics for pes cavus or pronation of the foot. Promote flexibility, strengthening, and proprioceptive programs (particularly for the VMO).

Other preventative measures may be sport specific, depending upon the equipment being utilized. For example, with cycling, the seat height should be properly adjusted. For cyclists with femoral anteversion or tibial torsion, floating clips or shims on the pedals may prevent patellofemoral syndromes. For runners, proper shoe maintenance can prevent problems.

Moderation of frequency or intensity of activity can also prevent problems. When a new activity is initiated, it should be done in a slow, progressive manner. Intensity levels should not change drastically over relatively short time periods. Runners, in particular, often follow a 10% rule, in which distance or time is increased by 10% on weekly intervals.

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Prognosis

Empiric treatment is successful in 80% of cases of patellofemoral joint syndrome. The treatment goal is to control the symptoms (ie, decrease the pain).

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Education

Education consists of the clinician being able to describe the condition anatomically and biomechanically to the patient. Because the problem is primarily one of pain, educate athletes about flexibility, strengthening, and proprioceptive programs, as well as the importance of using the proper equipment.

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