Dr Ronald Grelsamer is an associate clinical professor at the Mount Sinai Hospital in New York.

He has decades of experience in managing problems of the knee related to the patella . In this course he gives a comprehensive overview of those conditions that can cause pain in the patellar region.

The course consists of:

patellar tendon

Important patellofemoral concepts

Differential diagnosis of patellofemoral pain

  • conditions interfering with the mechanics of the knee
  • knee problems not necessarily involving the mechanics of the knee
  • ' Complex Regional Pain Syndrome '
  • 'referred pain', not originating with the knee at all

Conditions interfering with patellofemoral mechanics

  • tight structures around the knee
  • loose structures around the knee
  • factors increasing the Q-angle
  • overuse
  • deformed bones
  • stressed bones

Conditions causing patellofemoral pain but NOT interfering with the mechanics of the knee

  • knee problem but not necessarily involving the extensor mechanism
  • complex regional pain syndrome
  • referred pain from the hip and spine

Symptoms associated with patellofemoral pain

  • the nature of the injury
  • the nature of the discomfort
  • history of swelling
  • noises in the knee
  • pseudolocking, instability , catching

Examination in cases of patellofemoral pain

  • examination standing
  • sitting at the edge of the examination table
  • supine (lying on one's back)
  • prone (lying on one's stomach)
  • decubitus position (lying on one's side)

Imaging and X-rays for patellofemoral pain

Non-operative treatment for patellofemoral pain

  • preventing Overuse
  • mechanical support and improvement of posture
  • releasing tight structures on the lateral side
  • improving muscle balance
  • relieving local inflammation
  • artificial lubricants -Synvisc
  • diet & nutritional supplements

Surgery for Patellar Mal-alignment

  • releasing tight structures on the lateral side
  • tightening incompetent structures on the medial side
  • repositioning of the tibial tubercle

Surgery to slow established patellofemoral arthritis

Glossary

 

 

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