Hopp til hovedinnhold

Patellofemoralt smertesyndrom

Sist revidert:
Sist revidert av:


Definisjon:
Fremre knesmerter som synes å skyldes dysfunksjon i musklene som tilpasser patella til underliggende strukturer ved bevegelser i kneet
Forekomst:
Insidens på ca. 10% blant de med knesmerter som søker allmennlege. Hyppig blant idrettsutøvere og hyppigere blant kvinner
Symptomer:
Diffuse knesmerter som fremkommer ved aktiviteter som løp, hopp, trappegang, benbøyninger eller huksittende stillinger
Funn:
Kliniske tester kan styrke mistanken om diagnosen
Diagnostikk:
Diagnosen er primært klinisk. Bildediagnostikk brukes ev. til å utelukke andre tilstander
Behandling:
Konservativ behandling i form av avlastning og styrkeøvelser
  1. Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019;99(2):88-94. PMID: 30633480 PubMed  
  2. Crossley KM, Stefanik JJ, Selfe J, et al. 2016 patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016;50(14):839–843. PMID: 27343241 PubMed  
  3. Piva SR, Fitzgerald GK, Irrgang JJ, et al. Associates of physical function and pain in patients with patellofemoral pain syndrome. Arch Phys Med Rehabil. 2009 Feb. 90(2):285-95. PMID: 19236982. PubMed  
  4. Fagan V, Delahunt E. Patellofemoral pain syndrome: a review on the associated neuromuscular deficits and current treatment options. Br J Sports Med 2008; 42: 489-95. British Journal of Sports Medicine  
  5. Witvrouw E, Callaghan MJ, Stefanik JJ, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med 2014; 48:411. British Journal of Sports Medicine  
  6. Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med 2013; 47:193. British Journal of Sports Medicine  
  7. Potter PJ. Patellofemoral syndrome. Medscape, last updated Feb 06, 2015.
  8. Glaviano NR, Kew M, Hart JM, Saliba S. Demographic and epidemiological trends in patellofemoral pain. Int J Sports Phys Ther. 2015;10(3):281–290. PMID: 26075143 PubMed  
  9. Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med 2008; 7: 9. PubMed  
  10. Feller JA, Amis AA, Andrish JT et al. Surgical biomechanics of the patellofemoral joint. Arthroscopy 2007; 23: 542-53. PubMed  
  11. Cowan SM, Crossley KM, Bennell KL. Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med 2009; 43: 584-8. British Journal of Sports Medicine  
  12. Myer GD, Ford KR, Barber Foss KD, et al. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech (Bristol, Avon). 2010;25(7):700–707. PMID: 20466469 PubMed  
  13. Pappas E, Wong-Tom WM. Prospective predictors of patellofemoral pain syndrome: a systematic review with meta-analysis. Sports Health. 2012;4(2):115–120.
  14. Almeida GP, Silva AP, França FJ, Magalhães MO, Burke TN, Marques AP. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Rev Bras Ortop. 2016;51(2):181–186. PMID: 27069887 PubMed  
  15. Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med 2000; 28: 480-9. PubMed  
  16. Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Risk factors for patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2012;42(2):81–94. PMID: 22031622 PubMed  
  17. Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med 2002; 30: 447-56. PubMed  
  18. Elias DA, White LM. Imaging of patellofemoral disorders. Clin Radiol 2004; 59: 543-57. PubMed  
  19. Collins NJ, Barton CJ, van Middelkoop M, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med Published Online First: 20 June 2018 . doi:10.1136/bjsports-2018-099397 DOI  
  20. Yeung SS, Yeung EW, Gillespie LD. Interventions for preventing lower limb soft-tissue running injuries. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD001256. DOI: 10.1002/14651858.CD001256.pub2. DOI  
  21. Thomas MJ, Wood L, Selfe J, Peat G. Anterior knee pain in younger adults as a precursor to subsequent patellofemoral osteoarthritis: a systematic review. BMC Musculoskelet Disord. 2010;11:201. PubMed  
  22. van der Heijden RA, Lankhorst NE, van Linschoten R, et al. Exercise for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015 Jan 20;1:CD010387. PMID: 25603546. PubMed  
  23. Kooiker L, Van De Port IG, Weir A, et al. Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2014;44(6):391-B1. doi: 10.2519/jospt.2014.4127. PMID: 24766358. PubMed  
  24. Heintjes EM, Berger M, Bierma-Zeinstra SMA, Bernsen RMD, Verhaar JAN, Koes BW. Pharmacotherapy for patellofemoral pain syndrome. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD003470. DOI: 10.1002/14651858.CD003470.pub2. DOI  
  25. van Linschoten R, van Middelkoop M, Berger MY, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trail. BMJ 2009; 339: b4074. BMJ (DOI)  
  26. Crossley K, Bennell K, Green S, McConnell J. A systematic review of physical interventions for patellofemoral pain syndrome. Clin J Sport Med 2001; 11: 103-10. PubMed  
  27. O'Connor FG, Mulvaney SW. Patellofemoral pain. UpToDate, last updated Oct 16, 2018. www.uptodate.com  
  28. Chevidikunnan MF, Al Saif A, Gaowgzeh RA, Mamdouh KA. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. J Phys Ther Sci. 2016;28(5):1518–1523. PMID: 27313363 PubMed  
  29. Fukuda TY, Rossetto FM, et al.. Short-Term Effects of Hip Abductors and Lateral Rotators Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Controlled Clinical Trial. Journal of orthopaedic & sports physical therapy 2010; 40: 736-42. PMID: 21041965. PubMed  
  30. Manojlovic D, Kozinc Z, Sarabon N Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis. J Pain Res. 2021. PMID: 34079359 PubMed  
  31. Kurt EE, Büyükturan Ö, Erdem HR, Tuncay F, Sezgin H. Short-term effects of kinesio tape on joint position sense, isokinetic measurements, and clinical parameters in patellofemoral pain syndrome. J Phys Ther Sci. 2016;28(7):2034–2040. PMID: 27512259 PubMed  
  32. Callaghan MJ, Selfe J. Patellar taping for patellofemoral pain syndrome in adults. Cochrane Database Syst Rev. 2012;(4):CD006717. Cochrane (DOI)  
  33. Smith TO, Drew BT, Meek TH, et al. Knee orthoses for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015 Dec 8;12:CD010513. Cochrane (DOI)  
  34. Collins N, Crossley K, Beller E, et al. Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. BMJ 2008; 337: a1735. BMJ (DOI)  
  35. Blond L, Hansen L. Patellofemoral pain syndrome in athletes: a 5.7-year retrospective follow-up study of 250 athletes. Acta Orthop Belg 1998; 64: 393-400. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo