Patellofemoral Pain Syndrome

A syndrome characterized by retropatellar or peripatellar PAIN resulting from physical and biochemical changes in the patellofemoral joint. The pain is most prominent when ascending or descending stairs, squatting, or sitting with flexed knees. There is a lack of consensus on the etiology and treatment. The syndrome is often confused with (or accompanied by) CHONDROMALACIA PATELLAE, the latter describing a pathological condition of the CARTILAGE and not a syndrome.

Also Known As:

Networked: 413 relevant articles (47 outcomes, 91 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pain (Aches)
2.	Wounds and Injuries (Trauma)
3.	Osteoarthritis
4.	Musculoskeletal Pain
5.	Knee Osteoarthritis

Experts

1.	Crossley, Kay M: 17 articles (03/2021 - 12/2002)
2.	Rathleff, Michael Skovdal: 16 articles (01/2022 - 04/2012)
3.	Vicenzino, Bill: 14 articles (12/2021 - 02/2008)
4.	Powers, Christopher M: 14 articles (01/2019 - 10/2002)
5.	Fredericson, Michael: 11 articles (08/2020 - 05/2009)
6.	Barton, Christian J: 9 articles (01/2020 - 09/2008)
7.	de Oliveira Silva, Danilo: 8 articles (10/2021 - 10/2016)
8.	Cleland, Joshua A: 7 articles (01/2022 - 11/2008)
9.	Thorborg, Kristian: 7 articles (01/2022 - 01/2016)
10.	Matthews, Mark: 7 articles (12/2021 - 01/2016)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Patellofemoral Pain Syndrome:

1.	Botulinum Toxins (Botulinum Toxin)IBA 02/01/2022 - "Correction to: Botulinum toxin injections as a salvage therapy is beneficial for management of patellofemoral pain syndrome." 10/29/2021 - "Botulinum toxin injections as salvage therapy is beneficial for management of patellofemoral pain syndrome."
2.	Pain-FreeIBA 11/01/2015 - "Patients with patellofemoral pain did not display significantly greater patellar cartilage stress compared with pain-free controls; however, there was a great deal of subject variation. " 03/01/2021 - "Twenty women with a diagnosis of patellofemoral pain between 18 and 40 years of age and 20 age-matched pain-free controls participated in the study. " 01/01/2019 - "The aims of this study were threefold: (1) to compare the amplitude of patellar tendon reflex (T-reflex) between women with patellofemoral pain (PFP) and pain-free controls; (2) to compare the amplitude of vastus medialis Hoffmann reflex (VM H-reflex) between women with PFP and pain-free controls; (3) to investigate the association between the amplitude of patellar T-reflex and VM H-reflex in women with PFP and pain-free controls. " 08/01/2018 - "The primary purpose of this study is to determine whether recreational runners with patellofemoral pain (PFP) exhibit greater peak patella cartilage stress compared with pain-free runners. " 04/01/2018 - "Thirty-six adult males with patellofemoral pain and 36 pain-free males participated in the study. "
3.	Type A Botulinum Toxins (Botox)FDA Link 06/01/2011 - "Botulinum toxin type A for nonsurgical lateral release in patellofemoral pain syndrome: a case study." 02/01/2015 - "Anterior knee pain caused by patellofemoral pain syndrome can be relieved by Botulinum toxin type A injection." 01/01/2023 - "Botulinum neurotoxin type A improves vasti muscle balance, patellar tracking, and pain in patients with chronic patellofemoral pain." 02/01/2015 - "To investigate the therapeutic effects of Botulinum toxin type A (BTA) for anterior knee pain caused by patellofemoral pain syndrome (PFPS). "
4.	SiliconesIBA 08/01/1993 - "The efficacy of treatment of overuse patellofemoral pain with an elastic knee sleeve with a silicone patellar ring was compared with a simple elastic sleeve and with no treatment in a prospective study of 395 army recruits. "
5.	Non-Steroidal Anti-Inflammatory Agents (NSAIDs)IBA 11/01/2013 - "Patellofemoral pain (p < 0.0001), need for NSAIDs (p < 0.0001), longitudinal (p < 0.0001) and transversal (p < 0.0001) patellar glide tests, Zholen's sign (p = 0.0007) and knee effusion (p = 0.02) significantly improved in the follow-up. "
6.	Substance PIBA 01/01/1999 - "The aim of this study was to correlate the distribution of substance-P nerve fibres within the knee joint in 20 patients complaining of anterior knee pain syndrome, with the clinical picture, patellar motion, power of the quadriceps mechanism, and the psychological profile. " 01/01/2016 - "Substance-P in symptomatic mediopatellar plica as a predictor of patellofemoral pain." 11/01/2005 - "Distribution of substance-P nerves inside the infrapatellar fat pad and the adjacent synovial tissue: a neurohistological approach to anterior knee pain syndrome." 01/01/1999 - "Distribution of substance-P nerve fibers in the knee joint in patients with anterior knee pain syndrome. " 01/01/1999 - "For lateral retinaculum this relationship was not so statistically strong (P < 0.02) and was equal in comparison between anterior knee pain patients (group I) and group II or group III. There were no statistically significant differences in the distribution of substance-P nerve fibers in the fat pad, lateral and medial retinaculum or synovium between groups II and III. The results of this study provide immunohistochemical evidence suggesting that pain may originate in the fat pad and medial retinaculum of many patients with anterior knee pain syndrome."
7.	ElementsIBA 01/03/2014 - "Comparison of patella bone strain between females with and without patellofemoral pain: a finite element analysis study." 03/01/2011 - "Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: a finite element analysis study." 02/01/2019 - "We created subject-specific finite element models for 21 individuals with chronic patellofemoral pain and 16 pain-free control subjects. " 11/01/2015 - "We created finite element models of 24 patients with patellofemoral pain (11 males and 13 females) and 16 pain-free controls (8 males and 8 females) to estimate peak patellar cartilage stress (strain energy density) during a stair climb activity. "
8.	Opioid Analgesics (Opioids)IBA 03/01/2021 - "The purpose of this study was to compare downstream medical utilization-based outcomes (costs, visits, recurrent episodes) after an initial diagnosis of patellofemoral pain based on pre-injury utilization of opioids. " 03/01/2021 - "The influence of prior opioid use on healthcare utilization and recurrence rates for non-surgical patients seeking initial care for patellofemoral pain." 01/01/2020 - "Opioid history assessment should be standard practice for all patients with patellofemoral pain in whom an opioid prescription is considered."
9.	salicylhydroxamic acid (SHAM)IBA 02/01/2016 - "Fifteen females with patellofemoral pain were randomized to receive a single 15-minute treatment of either a patterned electrical neuromuscular stimulation or a sham. " 05/08/2018 - "Adults with patellofemoral pain, randomized controlled trials only, any conservative treatment compared with placebo, sham, other conservative treatment, or no treatment. "
10.	NeuropeptidesIBA 01/01/2016 - "The present study aimed to investigate the expression of a neuropeptide of symptomatic mediopatellar plica (MP) to prove that there was a significant correlation between the expression of substance-P (SP) in MP and patellofemoral pain. "

Therapies and Procedures

1.	Exercise Therapy (Therapy, Exercise) 12/12/2022 - "Growing evidence supports that exercise therapy is effective for patellofemoral pain (PFP) rehabilitation. " 01/01/2016 - "Efficacy of live feedback to improve objectively monitored compliance to prescribed, home-based, exercise therapy-dosage in 15 to 19 year old adolescents with patellofemoral pain- a study protocol of a randomized controlled superiority trial (The XRCISE-AS-INSTRUcted-1 trial)." 01/01/2022 - "Effectiveness of adjunctive treatment combined with exercise therapy for patellofemoral pain: a protocol for a systematic review with network meta-analysis of randomised controlled trials." 01/01/2018 - "This was the first study to investigate adherence to, and clinical effects of, exercise therapy and patient education in young adolescents with patellofemoral pain. " 01/01/2016 - "Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain-An ancillary analysis of a cluster randomized trial."
2.	Foot Orthoses 09/01/2011 - "There is emerging evidence that foot orthoses are effective in the management of patellofemoral pain syndrome (PFPS). " 12/01/2011 - "The aim of this study was to test whether patellofemoral pain is improved after four weeks of using custom-made foot orthoses. " 05/01/2010 - "The efficacy of foot orthoses in the treatment of individuals with patellofemoral pain syndrome: a systematic review." 01/01/2004 - "Identification of individuals with patellofemoral pain whose symptoms improved after a combined program of foot orthosis use and modified activity: a preliminary investigation." 08/02/2020 - "HAPPi Kneecaps! Protocol for a participant- and assessor-blinded, randomised, parallel group feasibility trial of foot orthoses for adolescents with patellofemoral pain."
3.	Psychology Biofeedback (Biofeedback) 01/01/2022 - "Efficacy of Patellar Taping and Electromyographic Biofeedback Training at Various Knee Angles on Quadriceps Strength and Functional Performance in Young Adult Male Athletes with Patellofemoral Pain Syndrome: A Randomized Controlled Trial." 01/01/2021 - "Efficacy of Electromyographic-Biofeedback Supplementation Training with Patellar Taping on Quadriceps Strengthening in Patellofemoral Pain Syndrome among Young Adult Male Athletes." 02/01/2008 - "Biofeedback exercise improved the EMG activity ratio of the medial and lateral vasti muscles in subjects with patellofemoral pain syndrome." 12/01/2001 - "Electromyographic biofeedback treatment did not result in further clinical improvement when compared with a conventional exercise program in patients with patellofemoral pain syndrome." 01/01/2021 - "This study compares the effects of electromyographic-biofeedback (EMG-BF)-guided isometric quadriceps strengthening with patellar taping and isometric exercise alone in patellofemoral pain syndrome (PFPS) among young adult male athletes. "
4.	Physical Therapy Modalities (Physical Therapy Technique) 10/01/2012 - "Although physical therapy is known to be effective in treating patellofemoral pain (PFP), there is considerable individual variation in the treatment response. " 08/01/2003 - "Physical therapy was effective for patellofemoral pain." 10/01/2023 - "OBJECTIVE: To test whether a series of brief, psychologically informed educational videos added to physical therapy improved function among adolescents with patellofemoral pain. " 09/01/2021 - "The randomised controlled trial was conducted from July to December, 2019, at the physical therapy department of Sahat Clinic, Rawalpindi, Pakistan, and comprise participants of both genders having patellofemoral pain who were randomised into mobilisation with movement group A and Mulligan knee taping group B. " 01/01/2020 - "This study provides preliminary evidence that incorporating a brief one-time psychologically-informed video into standard physical therapy care may significantly reduce maladaptive psychological beliefs in adolescents with patellofemoral pain."
5.	Orthotic Devices (Orthosis) 10/01/2000 - "Additionally, the functional significance of timing differences between the vastus medialis oblique and vastus lateralis is an important consideration in patellofemoral pain treatment and orthoses may be beneficial for some patients depending on their running mechanics." 07/01/2018 - "The results from this study indicate that lateral orthoses may be effective in attenuating runners risk from medial tibiofemoral compartment OA, but that wedged orthoses may enhance their risk from patellofemoral pain." 04/01/2023 - "Future studies should delve into the effects of the knee orthosis in individuals with patellofemoral pain." 01/01/2011 - "a randomized case-control trial with crossover between contoured and flat orthoses was conducted on ten individuals with patellofemoral pain and ten healthy participants. " 01/01/2019 - "Knee Orthoses for Treating Patellofemoral Pain Syndrome."