Chondromalacia - Patellofemoral Pain Syndrome or PFPS

Signs and Symptoms of Patellofemoral Pain Syndrome

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Patellofemoral pain syndrome (PFPS), is the medical name for conditions often called chondromalacia, kneecap pain, or more simply, "runner's knee."

The exact source of pain in these patients with PFPS is a subject of debate.  Traditionally, people have thought that the pain is a result of irritation of the cartilage on the back of the kneecap.  As the kneecap moves up and down, unevenly applied forces were thought to cause irritation to the cartilage.

  The problem is that cartilage is essentially free of any nerve endings--you can't feel your cartilage.  Others believe the pain is the result of irritation to the soft tissues surrounding the kneecap or the bone that supports the cartilage of the kneecap.

What we do know is that many people with this condition have similar examination findings, and a similar appearance of the cartilage when viewed during surgery.  The cartilage in people with PFPS is often characterized by blistering, fissuring, and fraying of the normally smooth cartilage surface.  In some more severe cases, the cartilage may become thin, giving the appearance of early arthritis of the knee.

Causes of PFPS

PFPS is interesting in that it often affects young, otherwise healthy, athletic individuals. Women are more commonly diagnosed with PFPS. Exactly why this is the case is unknown, but it is thought to have to do with anatomical differences between men and women, in which women experience increased lateral forces on the patella.

There are many causes of anterior knee pain, or pain around the kneecap, some of the more common include:

Patients should be evaluated by someone who is knowledgeable of these different diagnoses as an accurate diagnosis can help guide optimal treatment.

Treatment of PFPS

The treatment of PFPS remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. Allowing the inflammation of PFPS to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to athletic activity is always the first step in treatment.


Post WR. "Anterior Knee Pain: Diagnosis and Treatment" J Am Acad Orthop Surg December 2005 vol. 13 no. 8 534-543.​​​​

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