Patellofemoral pain syndrome (PFPS)

Diagnosis

The following procedure will help the doctor to diagnose PFPS:

• Physical examination: To differentiate patellofemoral pain from other conditions with similar symptoms and signs, a healthcare provider will typically inquire about any prior knee problems the patient may have had. They will also conduct a physical examination of the knee and ask the patient to move their leg into different positions.
• Imaging test:
  • X-rays: In order to produce X-ray images, a small quantity of radiation must flow through the body. While this technique provides a clear visualization of bones, it is relatively less effective at imaging soft tissues.
  • CT scans: These provide cross-sectional pictures of inside structures by combining X-ray images taken at various angles. Bone and soft tissues can be seen using CT scans, but the procedure exposes the patient to a higher radiation exposure than standard X-rays do.
  • MRI: MRIs provide finely detailed images of bones and soft tissues, including the cartilage and ligaments in the knees, using radio waves and a powerful magnetic field.

Treatment

The initial treatment for patellofemoral pain typically involves simple measures. Resting the knee is recommended, and activities that exacerbate the pain, such as stair climbing, kneeling, or squatting, should be avoided or adjusted.

• Home management: RICE method may help reducing the symptoms. RICE means Rest, Ice, Compression, and Elevation.
  • Rest: Refrain from bearing weight on the knee.
  • Ice: Do not apply ice directly on the knee. Instead, use cold packs wrapped in a towel for a maximum of 20 minutes, several times per day.
  • Compression: Lightly wrap the knee with an elastic bandage, leaving a gap over the kneecap. Avoid wrapping too tightly, as it could cause more pain.
  • Elevation: Rest with the knee elevated above the level of the heart.
• Medications: Use over-the-counter painkillers, such as acetaminophen, ibuprofen, or naproxen sodium, as necessary.
• Physical Therapy: You may improve your knee’s strength, endurance, and range of motion with the use of specific activities: A physical therapist may recommend the following:
  • Rehabilitation exercises: The quadriceps, hamstrings, and muscles around the hips, particularly the hip abductors, can all be strengthened with the use of specific exercises. These muscles support the knees and regulate limb alignment. The major objective is to correct the knee’s tendency to flex inward while squatting.
  • Supportive braces: May help improve pain by knee braces or arch supports.
  • Taping: To ease pain and improve the ability to exercise, physical therapist will demonstrate how to tape the knee.
  • Ice: Cold compression on the knee after exercise could be beneficial to the patient.
  • Knee-friendly sports: Patient might want to limit themselves to low-impact sports that are friendlier on their knees while they are recovering, such as swimming, water running, and biking.
  • Special shoes: The foot and ankle are aligned and stabilized by special shoe inserts. The lower leg and knee are less stressed due to the better alignment.
• Surgery: If non-surgical treatments for patellofemoral pain are unsuccessful, a healthcare provider may recommend surgical procedures such as:
  • Arthroscopy: An arthroscope, a pencil-thin instrument with a camera lens and light, is inserted into the knee during this surgery through a very small incision. To remove injured cartilage fragments, surgical instruments are inserted through the arthroscope.
  • Realignment: To correct the angle of the kneecap or relieve pressure on the cartilage, a surgeon may need to perform surgery on the knee in more serious conditions.