Patellofemoral pain syndrome is a group of symptoms related to the joint between the kneecap (patella) and its underlying groove in the femur bone, as well as the soft tissues related to the patella, such as the fat pad.

Page updated September 2023 by Dr Sheila Strover (Clinical Editor)

Hoffa fat pad
The condition is also known as 'anterior knee pain'. 



Causes of patellofemoral pain syndrome

In reality, although the pain is experienced in the front of the knee, the underlying cause may be remote - such as a hip problem or a bony rotation in the hip or thigh, or even a structural problem in the foot and ankle.

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Alignment issues resulting in patellofemoral pain

Pain experienced in the front of the knee may be a result of local alignment issues, such as -

  • tight structures at the side of the kneecap causing it to tilt, eg tight lateral retinaculum
  • when the attachment of the patellar tendon to the tibia is too far to the side
  • rotational or angular alignment problems of the long bones
  • constitutional laxity, allowing the patella to frequently sublux
  • flat feet

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Inflammation and impingement of local soft tissues

Pain may also result from impingement problems of the tissues under the patella, such as -

  • a synovial plica being nipped between patella and femur
  • an inflamed and impinging fat pad under the patella
  • inflammation of the synovial lining of the joint

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Patellofemoral syndrome
Anterior knee pain

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