Patellofemoral (anterior knee) pain syndrome: symptoms, causes and guideline based treatment options

The Patellofemoral Pain Syndrome (PFPS), also known as Anterior Knee Pain (AKP), is defined as: A complex of pain complaints around the patella (retro-/ peri-patellar), mainly non-traumatic of origin, which leads to a restriction during loaded activities, such as squatting, climbing stairs and cycling.1 Clinicians2 should make the diagnosis of PFPS using the following criteria: The presence of retro-patellar or peri-patellar pain, Reproduction of retro-patellar or peri-patellar pain with squatting, stair climbing, prolonged sitting, or other functional activities loading the Patellofemoral Joint (PFJ) in a flexed position, and Exclusion of all other conditions that may cause anterior knee pain, including tibiofemoral pathologies. Although treatment of patellofemoral pain often begins with simple measures like rest, avoidance or modification of activities that increase the pain, such as climbing stairs, kneeling or squatting or, if needed, over-the-counter pain relievers, most recommended interventions were exercise therapy, foot orthoses, patellar taping, patient education and combined interventions. Not recommended were manual therapy (in isolation), dry needling, patellar bracing, and electrotherapeutic modalities. To evaluate subjective symptoms and functional limitations PROMs (Patient Reported Outcome Measures), such as the KPS/AKPS,3 KOOS-PF4 and VAS/NPRS, are valid and reliable assessments.