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Patellofemoral joint pain

Back to Patient education: knee

What is patellofemoral joint pain?

Patellofemoral joint pain refers to pain in the front of the knee and around the kneecap (the patella). Also known as “runner’s knee,” it is one of the most common knee conditions among athletes, especially young female athletes. Patellofemoral pain can also occur in non-athletes due to a misaligned kneecap.

What causes patellofemoral joint pain?

This condition develops from the wearing down, roughening or softening of cartilage under the kneecap. Causes include overuse of the knee from vigorous athletics or excessive training, knee injury, muscle imbalance, abnormal tracking of the kneecap in the trochlear groove, and flat feet.

What are the symptoms?

The most common symptoms are knee pain and stiffness, especially when squatting or kneeling, descending the stairs or sitting with bent knees. Some people experience knee buckling, in which the knee suddenly gives way. Other symptoms include a catching or popping sound when moving the knee, or a grinding sensation when walking. In some cases, swelling develops around the patella.

How is patellofemoral joint pain diagnosed?

In addition to a complete medical history and physical exam, your doctor may order imaging tests, such as an X-ray or MRI, to view the tissue inside your knee, confirm the diagnosis, and rule out any other condition including osteoarthritis.

What is the treatment?

Most cases of patellofemoral joint pain resolve in time if the knee is not overused. In addition to rest, helpful measures include anti-inflammatory medications, activity modification, taping or bracing to stabilize the kneecap, physical therapy to strengthen the muscles around the kneecap, supportive running shoes and arch supports if you have flat feet.

Surgery is extremely rare and recommended only in severe cases that fail to respond to conservative treatment. Procedures include knee arthroscopy to remove damaged articular cartilage or correct patella alignment, and tibial tubercle transfer to realign the kneecap by moving the patellar tendon and the tibial tubercle – the bony part of the shinbone. Recovery time varies depending on the severity of your condition and type of procedure performed. It typically ranges from several weeks to several months.