要約

Patellofemoral stress syndrome is a diagnosis used to describe the condition of peripatellar pain without a history of trauma, anatomic malalignment, patellar instability, or clinical evidence of patellofemoral crepitus. The patient complains of pain with sporting events and when sitting with the knee flexed for extended periods of time. A complete history and evaluation should be performed to rule out any other diagnosis. This evaluation should include specific knee tests, lower extremity flexibility tests, and appropriate radiographs. Frequently, the patient displays a weak VMO, tight retinaculum, and tight iliotibial band. Once the patient is diagnosed with patellofemoral stress syndrome, the initial treatment should be conservative. This exercise program should consist of progressive resistive VMO strengthening, hip adduction, iliotibial band stretching, hamstring stretching, and gastrocnemius stretching. The patient should perform these exercises twice a day until symptoms subside and then continue three times per week as long as the patient remains active in sports. If this conservative approach fails, the surgical techniques of lateral release and lateral retinacular lengthening may be an option. The exercise program should be resumed after the surgical procedure to assist in obtaining successful results.