Patellofemoral Pain FAQs

A patellofemoral joint is made by kneecap which is a bone in the substance of the quadriceps muscle called patella. This bone articulates on the backside with the lower end of the thigh bone, or the femur and helps in smooth gliding of the quadriceps muscle over the knee joint.

Patella, the kneecap, moves on the knee joint to produce good motion. If there is any fraying or damage of the articular cartilages of the kneecap or if there is malalignment of the kneecap over the knee joint, then this may present as patellofemoral pain. This pain is essentially present in the front of the knee though it may radiate to either side too. It may be associated with grinding sensation and is usually worsened with stairs or change in position from sitting to standing or standing to sitting.

When the kneecap is not correctly aligned to the knee joint and tends to slip on movement of the knee joint, then the patient may present with pain as well as impaired functioning of the knee joint. Such patients may also present with complains of clicking, popping or feeling or tightness or instability. He may also have joint effusion.

Chondromalacia patella means degeneration of the cartilage of the kneecap or the knee which articulates with the kneecap. This usually presents with grinding sensation as well as noise from the knee joint, associated with pain and swelling. The pain is worsened usually by using stairs or walking for long periods.

Patients with lateral compression of the patella or the knee cap, over the knee, with knee pain in the front of the knee, especially worsened with stairs, can sometimes be relieved by a procedure called lateral release. In this procedure, the outer ligaments of the knee cap are released using arthroscopic surgery, to align the kneecap better over the knee.

This surgery is usually done if the patient has failed all conservative and non-operative treatment. This surgery may be followed by swelling of the knee, and, hence, needs thorough elevation and icing. Patients will also need to work with physical therapy to recover range of motion, as well as, relieve pain.

The patients with patellofemoral stress syndrome usually presents with pain, swelling, grinding or crunching sensation of the knee, especially while moving it. The pain is usually worsened while getting in and out of a chair or going up and down the chairs.

Patellar grind test is a test performed by the physician to intercept grinding noise and sensation along with or without pain by stressing the patella over the lower end of femur. In patients with patellofemoral cartilage damage, this test is usually positive.

Knee braces help in patients of patellar tendinitis by providing compression as well as support to the knee. They can be used in conjunction with medications and physical therapy.

If the kneecap or patella is fractured due to fall or accident, it requires treatment in the form of immobilization or surgery. If the fracture fragments are nondisplaced, then immobilization for four to six weeks may be enough to treat the fracture but if the fracture fragments are displaced, then surgery may be needed to realign the fracture fragments and allow proper healing to allow the proper functioning of the quadriceps.

The patients with fractured or broken patella or kneecap can still walk with a knee brace in place and keeping the knee in straight position.

A dislocated kneecap is a painful condition and the patient will usually not be able to walk till the dislocation is reduced. If the patient has a dislocated knee, which is usually caused in high energy motor vehicle accident, then it is an emergency and the patient should be taken to the hospital as soon as possible to prevent long-term effects of injury or compression to the nerves and vessels around the knee joint.

Patellar tendon can be torn in patients with sudden excessive forces along the knee joint. They present with sudden onset of pain and swelling around the knee and inability to stand or walk on the leg. These patients will usually be treated with surgical repair of the patellar tendon or quadriceps tendon.

Rarely patients with bad fractures of the kneecap may require surgery in the form of removal of the kneecap. These patients can still be able to walk without the kneecap after the successful surgery.