Detailed guides to painful problems, treatments & more

Patellofemoral pain syndrome

PainSci » bibliography » Petersen et al 2014
Tags: patellar pain, etiology, treatment, arthritis, aging, pain problems, knee, leg, limbs, overuse injury, injury, running, exercise, self-treatment, pro

One page on PainSci cites Petersen 2014: The Complete Guide to Patellofemoral Pain Syndrome

PainSci commentary on Petersen 2014: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This paper is a general review of patellofemoral pain and is a fine example of all the best in conventional wisdom. On the one hand, it is a generally credible mainstream scientific publication with plentiful citations providing at least some support for its key points. On the other? Most of those points remain controversial and have been credibly challenged by various experts, some of the support is weak to the point of being bogus.

As one example, the authors acknowledge, barely, that patellar maltracking is controversial, but they wave it away: “Recent studies, however, show that maltracking of the patella probably plays a key role.” But their citations are not persuasive, and they do even attempt to address any of the standard rebuttals.

The whole paper is quite rudimentary. But, for the sake of balance, if you wanted one scientific paper that represents the conventional wisdom, this is the citation you’re looking for!

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

The patellofemoral pain syndrome (PFPS) is a possible cause for anterior knee pain, which predominantly affects young female patients without any structural changes such as increased Q-angle or significant chondral damage. This literature review has shown that PFPS development is probably multifactorial with various functional disorders of the lower extremity. Biomechanical studies described patellar maltracking and dynamic valgus in PFPS patients (functional malalignment). Causes for the dynamic valgus may be decreased strength of the hip abductors or abnormal rear-foot eversion with pes pronatus valgus. PFPS is further associated with vastus medialis/vastus lateralis dysbalance, hamstring tightness or iliotibial tract tightness.

The literature provides evidence for a multimodal non-operative therapy concept with short-term use of NSAIDs, short-term use of a medially directed tape and exercise programmes with the inclusion of the lower extremity, and hip and trunk muscles. There is also evidence for the use of patellar braces and foot orthosis. A randomized controlled trial has shown that arthroscopy is not the treatment of choice for treatment of PFPS without any structural changes. Patients with anterior knee pain have to be examined carefully with regard to functional causes for a PFPS. The treatment of PFPS patients is non-operative and should address the functional causes.

This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:

PainSci Member Login » Submit your email to unlock member content. If you can’t remember/access your registration email, please contact me. ~ Paul Ingraham, PainSci Publisher