الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
Patellofemoral Pain Syndrome (PFPS) is a term for a variety of pathologies or anatomical abnormalities leading to anterior or retropatellar pain which exacerbates during sustained sitting, kneeling, ascending or descending stairs, and squatting after exclusion of the other causes of anterior knee pain.
Etiology of patellofemoral pain syndrome is multifactorial.The basic disorder is probably mechanical overload of the patello-femoral joint due to malalignment of the patella that leads to excessive compressive stress to the patellar facets. Factors that may contribute to abnormal patella tracking include quadriceps weakness, quadriceps muscle imbalances, excessive knee soft tissue tightness, an increased quadriceps angle (Q-angle), hip abductors and external rotators weakness, and altered foot kinematics.
The aim of interventions used for the treatment of PFPS is to improve patella tracking and reduce abnormal stress to patellofemoral joint structures.
Conservative treatment includes education, modification of activity, pharmacotherapy, patellar correction techniques such as taping and bracing, foot orthoses and physical therapy. Most patients with PFPS respond well to conservative interventions.
Physical/ exercises Therapy aim to improve quadriceps weakness, specifically VMO weakness in comparison to the VL, by quadriceps strengthening exercises. Exercises can be subdivided into closed chain (foot in contact with another surface such as the floor or bicycle pedal) or open chain (foot is free) types.
Surgical treatment for PFPS considered for patients whose symptoms persist despite their completing at least 6 to 12 months of a conservative treatment, and who have a genuinely surgically correctible problem such as patellofemoral malalignment or articular cartilage injury.
Surgical treatment procedures are: (1) Proximal realignment surgery involving the soft-tissue structures of the knee is performed to either tighten the medial side (medial reefing, VMO advancement, MPFL repair or reconstruction) or loosen the lateral tight side (lateral release).
(2) Distal realignment procedures consist of tibial tubercle transfers with the patellar tendon to restore normal patellar tracking with unloading of damaged articular surfaces. (3)Trochleoplasty. (4) Patellectomy.
Management of articular cartilage lesions by:
(1) Debridement.
(2) Marrow stimulating techniques by chondroplasty and microfracture .
(3) Replacement : By mosaicplasty and allograft.
(4)Chondrocyte implantation neither with autologous chondrocyte implantation(ACI) or Matrix-assisted Chondrocyte Implantation (MACI).
(5) Patellofemoral arthroplasty.