Patellofemoral Pain and Instability in Adolescent Athletes.

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Abstract

[Indexed for MEDLINE] 20. J ISAKOS. 2024 Aug;9(4):806-813. doi: 10.1016/j.jisako.2024.06.004. Epub 2024 Jun 17. Physiopathology of patello-femoral osteoarthritis: current concepts. Arias C(1), Lustig S(2). Author information: (1)Hospital Edgardo Rebagliati Martins, Lima, Peru. Electronic address: Claudia_arias81@hotmail.com. (2)Orthopedic Surgery Department, Croix-Rousse Hospital, 103 Grande rue de la Croix-Rousse, 69004 Lyon, France. Patellofemoral osteoarthritis (PFOA) is the result of degeneration and loss of articular cartilage of the patella and trochlea, and is a common cause of anterior knee pain. PFOA is triggered by insufficient adaptation to overload of the articular cartilage of the PF joint created by abnormal biomechanics. It is important to understand the pathophysiology and natural history to make the diagnosis and to plan treatment. Innate factors including malalignment, patellar instability, kinematic disorders, and acquired factors like trauma, obesity, and endocrine diseases have been found to be causes of PFOA. Genetic predisposition is also described as a contributing cause but without much scientific evidence. The diagnosis will be based on clinical manifestations, such as anterior knee pain aggravated by overloading activities, identification of risk factors, and exclusion of referred pain from other pathologies, followed by a systematic and structured physical examination. Imaging will be useful for assessing the presence of early osteoarthritis in the other compartments, for classification of the PFOA, and to identify features to establish an adequate treatment. This paper discusses varying management options for different causes of patellofemoral disease and explains the complexity of the PF joint and its often poorly understood biomechanics. Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jisako.2024.06.004