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Patellofemoral pain in athletes

Authors Petersen W, Rembitzki I, Liebau C

Received 27 January 2017

Accepted for publication 20 March 2017

Published 12 June 2017 Volume 2017:8 Pages 143—154

DOI https://doi.org/10.2147/OAJSM.S133406

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Andreas Imhoff


Wolf Petersen,1 Ingo Rembitzki,2 Christian Liebau3

1Department of Orthopaedic and Trauma Surgery, Martin Luther Hospital, Grunewald, Berlin; 2German Sport University Cologne, 3Asklepios Clinic, Bad Harzburg, Germany

Abstract: Patellofemoral pain (PFP) is a frequent cause of anterior knee pain in athletes, which affects patients with and without structural patellofemoral joint (PFJ) damage. Most younger patients do not have any structural changes to the PFJ, such as an increased Q angle and a cartilage damage. This clinical entity is known as patellofemoral pain syndrome (PFPS). Older patients usually present with signs of patellofemoral osteoarthritis (PFOA). A key factor in PFPS development is dynamic valgus of the lower extremity, which leads to lateral patellar maltracking. Causes of dynamic valgus include weak hip muscles and rearfoot eversion with pes pronatus valgus. These factors can also be observed in patients with PFOA. The available evidence suggests that patients with PFP are best managed with a tailored, multimodal, nonoperative treatment program that includes short-term pain relief with nonsteroidal anti-inflammatory drugs (NSAIDs), passive correction of patellar maltracking with medially directed tape or braces, correction of the dynamic valgus with exercise programs that target the muscles of the lower extremity, hip, and trunk, and the use of foot orthoses in patients with additional foot abnormalities.

Keywords: anterior knee pain, dynamic valgus, hip strength, rearfoot eversion, single leg squat, hip strength
 

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