Patellofemoral Pain Syndrome

Also known as chondromalacia patellae or anterior knee pain syndrome — the most common overuse injury of the knee.

• Demographics: runners and cyclists (especially after an increase or change in training); young females most at risk; older adults (50–70) with patellofemoral-joint OA.
• History:
  • pain behind or around the patella
  • pain descending stairs
  • pain on standing after prolonged sitting (“movie-goer’s knee”).
• Examination:
  • tenderness around the patellar edges
  • crepitus under the patella on flexion/extension greater than the non-painful side (crepitus without pain has limited significance)
  • pain on moving the patella under compression (Perkins/Clarke-type test — press down on the patella, then glide it medially and laterally).
• Investigations: none required — clinical diagnosis.
• Management:
  • reduce the aggravating activity, then slow graded return
  • physiotherapy — quadriceps (and hip/calf) strengthening is the cornerstone
  • correct underlying biomechanical abnormality (foot posture, training load)
  • NSAIDs for short-term pain relief.

Benign condition with a good prognosis.