Ocean County Sports Medicine Dr Joe Tauro

How is patellofemoral pain syndrome treated?

Non-Operative Treatment

Patellofemoral pain syndrome can usually be effectively treated with a non-operative treatment program. It can take the knee six weeks or more to show improvement once treatment begins; this is often the same length of time the pain has been present. The following options are typically used in a conservative treatment program:

Activity modification: physical activities should by decreased by 30% and should be limited to those with no impact, such as swimming or bicycling. Uphill walking or treadmill at a 7% grade is also a good choice. Exercises that cause pain should be avoided.
Anti-inflammatory medication such as ibuprofen may be recommended
Icing
Physical therapy to reduce inflammation and to strengthen and rebalance the muscles about the knee.
A knee sleeve, splint, or taping that will support the joint during healing. (Special sleeves can keep the patella tracking properly during motion.)
Special footwear or orthotics can support the arch and absorb impact.

Four to six weeks after treatment begins the patient will usually return for a follow-up appointment. At this time the doctor will evaluate the success of the program. There is near full improvement, a home exercise program will be instituted. If there is partial improvement, physical therapy may be continued. If the symptoms have not improved after at least 2 or 3 months of treatment, surgery may be recommended.

Operative Treatment

Surgery is only considered as a last resort, when conservative treatment has failed to alleviate symptoms.

A diagnostic arthroscopy allows the doctor to examine and treat the inside of the joint. In this procedure, instruments are inserted through small incisions in the knee. Rough or frayed spots in the cartilage that covers the bone can be smoothed, plica can be trimmed, and the patella can be realigned if necessary. In more severe cases of patellar malalignment, open surgery may be necessary to correct the Q-angle in order to fully stabilize the kneecap.

What types of complications may occur?

The most common complications from surgery are persistent swelling, loss of muscle tone, and scar tissue formation.