Patellofemoral Pain Syndrome: A Critical Analysis of Current Concepts

Abstract

Patellofemoral pain syndrome (PFPS) is one of the most common diagnoses treated by physical therapists in the orthopedic setting. The etiological mechanism of PFPS is poorly understood, however it is purported that biomechanical dysfunction of the patellofemoral joint leads to anterior knee pain and decreased function. Current rehabilitation of PFPS focuses on restoring normal patellofemoral mechanics by resolving patellofemoral malalignment, promoting tissue extensibility, promoting optimal timing and strength of the vastus medialis obliquus muscle, and normalizing mechanics of the subtalar joint. However, most of the aforementioned management strategies have not been subjected to scientific scrutiny and therefore lack an evidence-base. The expansive range of therapies currently being utilized is an indication that there is little consensus on the most efficient and effective management strategies for PFPS. The purpose of this paper is to discuss the normal anatomy and biomechanics of the patellofemoral joint in detail and provide a critical analysis of the current literature as it relates to conservative management of PFPS.