Introduction
Patellofemoral Syndrome, commonly referred to as runner's knee or chondromalacia patellae, is characterized by knee pain resulting from misaligned knee structures, injury, or overuse. This condition arises when the cartilage beneath the kneecap becomes overstressed or begins to deteriorate, leading to pain and functional impairment. Treatment options typically include rest, knee bracing, medications, and physical therapy. In certain cases, surgical intervention may be required to smooth out damaged cartilage or to realign the kneecap.
Anatomy
The knee is a complex joint made up of three main bones: the femur (thighbone), the tibia (larger leg bone), and the patella (kneecap). The kneecap moves within a groove on the femur, while four major ligaments provide stability by connecting these bones. Large muscle groups in the thigh contribute to strength and mobility. Cartilage on the bone ends and beneath the kneecap facilitates smooth movement, while the synovial membrane secretes synovial fluid to lubricate the joint and nourish the cartilage, acting as a shock absorber during activities like walking or running.
Causes
Patellofemoral Syndrome typically develops when the cartilage beneath the kneecap softens and degenerates. This can result from repetitive strain, misalignment of the knee structures, or injury. Activities such as skiing, cycling, running, and soccer are commonly linked to this syndrome. Additionally, chronic cases may lead to arthritic changes in the kneecap.
Symptoms
Individuals with patellofemoral syndrome may experience a dull ache in the knee, swelling, and tenderness. Pain often intensifies after prolonged sitting or during specific activities like climbing stairs, kneeling, squatting, or rising from a seated position. You may also notice a grinding sensation in the knee when extending it.
Diagnosis
A healthcare provider can diagnose Patellofemoral Syndrome by examining the knee and leg and taking a detailed medical history. X-rays are typically performed to assess knee alignment and check for signs of arthritis. In some cases, further imaging such as CT scans or MRIs may be utilized to evaluate patellar tracking and assess cartilage surfaces more clearly.
Treatment
The primary objective of treatment is to alleviate pain and restore knee mobility and function. This may involve resting and avoiding strenuous activities until symptoms improve. A knee brace or custom orthotics can offer support during activities. Your doctor may suggest using ice packs or over-the-counter anti-inflammatory medications to manage pain and swelling. A referral to physical therapy for targeted strengthening and flexibility exercises is often beneficial.
Surgery
In some cases, surgical intervention may be necessary to correct knee misalignments. Realignment surgery can reposition the kneecap, while arthroscopic techniques may be employed to adjust the patella and remove damaged cartilage. Arthroscopic surgery utilizes small incisions and specialized instruments, minimizing recovery time, pain, and bleeding compared to traditional open surgery. However, if the misalignment cannot be treated arthroscopically, open surgical options may be discussed.
Recovery
Recovery from Patellofemoral Syndrome varies depending on factors such as the underlying cause and the treatment approach utilized. Your healthcare provider will guide you on what to expect during your recovery journey.
