Patella Problems (Patellofemoral Syndrome)

This syndrome is caused by changes in the undersurface of the kneecap (patella). The changes vary from minor inflammation to major changes such as breakdown of the cartilage on the undersurface of the patella. The major changes can be seen with an arthroscope (a small, pencil-sized telescope). These changes can result from various factors. These factors may arise from abnormal tracking (movement or malalignment) of the patella. Normally the Patella is in its normal groove located between the condyles (grooved end) of the femur (thigh bone). Abnormal movement leads to increased pressure in the patellofemoral joint. This leads to swelling in the cartilage, inflammation and pain.

SYMPTOMS

The patient with this syndrome usually has an ache in the knee. It is often aggravated by:

  • Prolonged sitting.

  • Squatting.

  • Climbing stairs.

  • Running down hill.

  • Other exercising that stresses the knee.

Other findings may include the knee giving way, swelling, and or locking.

TREATMENT

The treatment will depend on the cause of the problem. Sometimes the solution is as simple as cutting down on activities. Giving your joint a rest with the use of crutches and braces can also help. This is generally followed by strengthening exercises.

RECOVERY

Recovery from a patellar problem depends on the type of problem in your knee and on the treatment required. If conservative treatment works the recovery period may be as little as three to four weeks. If more aggressive therapy such as surgery is required, the recovery period may be several months. Your caregiver will discuss this with you.

HOME CARE INSTRUCTIONS

  • Following exercise, use an ice pack for twenty to thirty minutes three to four times per day. Use a towel between your ice pack and the skin.

  • Reduction of inflammation with anti-inflammatories may be helpful. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Taping the knee or using a neoprene sleeve with a patellar cutout to provide better tracking of the patella may give relief.

  • Muscle (quadriceps) strengthening exercises are helpful. Follow your caregiver's advice.

  • Muscle stretching prior to exercise may be helpful.

  • Soft tissue therapy using ultrasound, and diathermy may be helpful.

  • If conservative therapy is not effective, surgery may provide relief. During arthroscopy, your caregiver may discover a rough surface beneath your kneecap. If this happens, your caregiver may smooth this out by shaving the surface.

SEEK MEDICAL CARE IF:

If you have surgery, see your caregiver if:

  • There is increased bleeding or clear fluid (more than a small spot) from the wound.

  • You notice redness, swelling, or increasing pain in the wound.

  • Pus is coming from wound.

  • You develop an unexplained oral temperature above 102° F (38.9° C) develops, or as your caregiver suggests.

  • You notice a foul smell coming from the wound or dressing.

  • You develop increasing pain or stiffness in your knee.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a rash.

  • You have difficulty breathing.

  • You have any allergic problems.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.