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Commentary

N Maffulli, MD, PhD, is Senior Registrar and Clinical Lecturer in Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Aberdeen, Medical School, Polwarth Bldg, Foresterhill, Aberdeen AB9 2ZD, Scotland

This excerpt was created in the absence of an abstract.

Patellofemoral pain syndrome (PFPS) is one of the most frequent musculoskeletal disorders affecting athletic youngsters¹ and may account for up to 10% of the cases seen in a sports injury clinic.² This disorder is often attributed to chondromalacia of the patella, even though several studies have now shown that chondromalacia patellae is present as an incidental finding.³ Many patients with anterior knee pain also have normal patellar cartilage at arthroscopy.⁴

Retinacular pain associated with patellofemoral malalignment is the most frequent cause of anterior knee pain, and biopsies of the lateral retinaculum have shown that small nerves in this area can be injured as a result of chronic patellar imbalance.⁵ Over time, patellofemoral imbalance can cause articular damage because of increased local stresses and decreased normal loading of the articular cartilage.⁶

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