Rethinking patellofemoral pain: Prevention, management and long-term consequences

Publication date: Available online 22 February 2019Source: Best Practice & Research Clinical RheumatologyAuthor(s): Kay M. Crossley, Marienke van Middelkoop, Christian J. Barton, Adam G. CulvenorAbstractPatellofemoral pain is one of the most common knee complaints, particularly among physically active young individuals. Although once thought to be self-limiting, prospective studies have demonstrated the propensity towards the chronicity of patellofemoral pain (PFP). The pathogenesis of PFP is complex, with multiple interactive pathways suggested to contribute to its onset and persistence. Quadriceps weakness is one of the few risk factors of PFP, with at least moderate evidence from prospective studies, although limited clinical trials of lower limb strengthening have generally not been successful in preventing PFP. The challenge of managing PFP is reflected by a lack of evidence-based clinical guidelines. International consensus and current evidence recommends exercise therapy, focussed on hip and knee strengthening, as a cornerstone of management to reduce PFP. Rethinking management approaches beyond exercise therapy to incorporate movement retraining, education and psychosocial aspects provides potential avenues to enhance outcomes for patients with PFP.

Source: Best Practice and Research Clinical Rheumatology - February 23, 2019 Category: Rheumatology Source Type: research