Pain in the front of the knee (often called “runner’s knee” or “jumper’s knee”) is also known as patellofemoral pain. It is caused by abnormal mechanics of the kneecap gliding in the femoral trochlea. It can occur in both athletes and non-athletes. Pain is usually described as anterior knee pain, swelling, and stiffness. Patients often describe a grinding sensation under the kneecap. Aggravating factors include squatting, going up and down stairs, and prolonged sitting.
Patellofemoral pain can be caused from overuse during training and activity but is often caused by poor alignment of the kneecap. A good history, physical exam and X-rays can confirm the diagnosis.
Non-surgical treatment includes rest, ice, activity modifications, NSAIDS, and physical therapy. Orthotics are sometimes recommended to help stabilize the foot and ankle and reduce stress through the knee.
Failure of conservative treatment often leads to an arthroscopy, debridement, and releasing the joint capsule on the outside of the knee called a lateral release. This helps to reduce stress in the patellofemoral joint and improve tracking of the kneecap.
Sometimes a tibial tubercle transfer is necessary to realign the kneecap to further improve kneecap tracking. This procedure involves cutting the attachment of the patellar tendon on the tibia and moving it anteriorly and medially and fixating the bone to the new position using 2 screws. Bracing and physical therapy are recommended after surgery for optimal recovery.
If you believe you have knee pain from a petellofemoral condition, consult with an orthopedic surgeon.