Definition

In this section you will find detailed information about the definition of patellofemoral pain. Let`s find out more?

Patellofemoral pain is a common musculoskeletal-related condition that is characterized by insidious onset of a diffuse pain, which can be located in the anterior, retropatellar and/or peripatellar region of the knee.1,2

Patellofemoral pain is not associated with episodes of direct knee trauma. On the opposite, the symptoms usually arises gradually and is associated with movement, especially during lower-limb loading activities (e.g., squatting, running, stair ambulation, and others). Symptoms can restrict participation in sports, and daily activities.2 Additionally, symptoms can recur even after treatment and can persist for years.3,4

According to the Patellofemoral Pain Consensus published in 20162 by a group of experts in the field, patellofemoral pain can be defined according to some criteria: the essential criteria and the additional criteria.

As the nomenclature suggests, the essential criteria are those that essentially must be presented by patients with patellofemoral pain, including pain around or behind the patella, which is aggravated by at least one activity that loads the patellofemoral joint during weight bearing on a flexed knee (e.g., squatting, stair ambulation, jogging/ running, hopping/jumping).

Additional criteria are those that may be present but are not essential in the clinical presentation of every patient with patellofemoral pain. They include crepitus or grinding sensation emanating from the patellofemoral joint during knee flexion movements; tenderness on patellar palpation; small effusion; and pain on sitting, rising on sitting, or straightening the knee following sitting.

 

Important note: Patients with a history of patellar dislocation or subluxation usually are considered to be a subgroup of people with patellofemoral disorders, who may have distinct clinical presentations, risk factors, and associated factors and, consequently, require different treatment approaches. Therefore, the findings of studies on patellofemoral pain usually do not apply to these patients in particular, as the vast majority of them meet the study exclusion criteria.2

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References

  1. Willy et al. 2019. Patellofemoral Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy. 
  2. Crossley et al. 2016. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. 
  3. Lankhorst et al. 2015. Factors that predict a poor outcome 5–8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. 
  4. Nimon et al. 1998. Natural history of anterior knee pain: a 14- to 20-year follow-up of nonoperative management.