Anterior Knee Pain and Patellofemoral Problems

Anterior knee pain Patients with patellofemoral pain represent a significant challenge to the orthopaedic and rehabilitation community, despite recent advances in the understanding of almost all other knee conditions. This clinical conundrum is often aptly named “The Black Hole of Orthopaedics”, implying that no single explanation or therapeutic approach has fully clarified this problem yet. The primary factor differentiating this clinical problem from other knee conditions is its inherent subjectivity. Anterior knee pain, or patellofemoral pain, is pain in the front of the knee which is often made worse by sitting for prolonged periods, stair climbing or any activity which involves bending the knee. It is often aggravated by sport. The origin of patellofemoral pain can be directly traced to supraphysiological mechanical loading and mechanical or chemical irritation of nerve endings. Studies have shown that patellofemoral pain syndrome (PFPS) comprises up to 50% of overuse injuries. Even activities of daily living can become supraphysiologic. This syndrome seems to be caused by the damage to the under surface of the patella, or patellofemoral articulating surfaces, often inappropriately called chondromalacia patella.