Excessive lateral pressure syndrome (ELPS) is a collection of symptoms and signs related to the edge of the kneecap being forced abnormally against the wall of the underlying groove.

lateral patellar tilt

Tight lateral structures or muscle imbalance may lead to tilt of the patella to the lateral side.

pain in MFPL from lateral tilt

This may put strain on the medial side and tenderness in the region of the medial patellofemoral ligament (MPFL)

excessive lateral pressure

Cartilage damage may occur on the lateral side from the increased pressure


Cartilage damage from ELPS

Anterior knee pain is exerienced, which tends to worsen as contact pressure increases when the knee is flexed. Over time the adjacent lateral patella and lateral femoral condyle may show damage to the joint cartilage and underlying bone.

Lateral patellar compression syndrome
Lateral hyperpressure syndrome
Lateral pressure in flexion syndrome

What are the common kneecap problems?

A quick overview of kneecap problems to help you with your research.

A discussion by Dr Ronald Grelsamer.

This is the editor's interpretation of a paper published in 2002, in which the authors stress that no 'corrective' surgery for patellofemoral malalignment should be undertaken on the basis of the imaging findings alone.



Diagnosis and Treatment of Lateral Patellar Compression Syndrom. Saper MG and Shneider DA. Arthrosc Tech. 2014 Oct; 3(5): e633–e638..

Hamstrings Loading Contributes to Lateral Patellofemoral Malalignment and Elevated Cartilage Pressures: An In Vitro Study. Elias JJ, Kirkpatrick MS, Saranathan A, Mani S, Smith LG and Tanaka MJ. Clin Biomech (Bristol, Avon). 2011 Oct; 26(8): 841–846.

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