patellofemoral

Patellofemoral describes aspects of the knee involving the articulation between the patella (kneecap) and the femur (thigh bone), including the patellofemoral joint and related soft tissues. The joint is formed where the posterior surface of the patella interfaces with the trochlear groove of the femur; the contact surface and its cartilage absorb load during knee bending. The quadriceps tendon, patellar ligament, and medial and lateral retinacula, along with hip and thigh musculature, influence patellar tracking.

Pathology commonly affects the patellofemoral region. The most frequent condition is patellofemoral pain syndrome (PFPS), which presents as anterior knee pain worsened by squatting, stair climbing, running, or sitting with bent knees. Overuse, maltracking, and anatomical variants contribute. Patellar instability or dislocation and chondromalacia patellae (cartilage softening) are other conditions. Patellofemoral osteoarthritis may develop with age or after injury.

Diagnosis relies on clinical history and physical examination, supported by imaging. Plain radiographs, often including skyline or Merchant views, assess alignment and joint space; MRI provides detailed evaluation of cartilage, bone, and soft tissues when needed.

Treatment is generally conservative initially. Physical therapy focusing on quadriceps strengthening (especially the vastus medialis obliquus), hip abductors and external rotators, plus flexibility work, is central. Activity modification, patellar taping or bracing, and analgesics may help. In persistent cases, surgical options such as realignment procedures, medial patellofemoral ligament reconstruction, trochleoplasty, or patellofemoral arthroplasty may be considered. Prognosis varies by condition, with many PFPS cases improving with rehabilitation, while patellofemoral osteoarthritis tends to be more chronic.