How is patellofemoral pain syndrome treated?
Most often, patients with patellofemoral pain syndrome will recover with non-surgical therapies such as RICE (rest, ice, compression, elevation), NSAIDs (non-steroidal anti-inflammatory drugs) for pain relief, and taping the knee to help correct the patella from tracking outside of the trochlear groove. After the pain and inflammation are managed, Dr. Nwachukwu will recommend a physical therapy regimen to strengthen the VMO while stretching the tight vastus lateralis and IT band.
In the rare cases where patellofemoral pain syndrome is resistant to non-surgical treatment and pain or inflammation persists, arthroscopic surgery may be performed to alleviate the condition. Dr. Nwachukwu will insert a small surgical camera (arthroscope) into the knee joint to visualize the articular cartilage underneath the patella, and assess one or more of several courses of action to relieve the pain:
- Debridement: An arthroscopic shaver is used to remove (debride) fibrillation (eroded areas of cartilage).
- Lateral Retinaculum Release: If the lateral retinaculum (a fibrous tissue that supports the outer side of the patella) is found to be tight enough to pull the patella laterally outside of the trochlear groove, a lateral release procedure can loosen the tissue and allow the patella to settle inside the groove once again.
- Tibial Tubercle Transfer: This procedure is most commonly used to treat patellofemoral instability, where the patella persistently tracks out of the trochlear groove. This is done through a midline incision over the knee, through which Dr. Nwachukwu will reposition the tibial tubercle (bony attachment at the top of the shin) and attached patellar tendon to a new insertion point on the tibia.