Treatment For Patellofemoral Pain Syndrome

Surgical treatment for patellofemoral pain is very rarely needed and is done only for severe cases that do not respond to nonsurgical treatment. Surgical treatments may include:

Arthroscopy. During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.

• Debridement. In some cases, removing damaged articular cartilage from the surface of the patella can provide pain relief.
• Lateral release. If the lateral retinaculum tendon is tight enough to pull the patella out of the trochlear groove, a lateral release procedure can loosen the tissue and correct the patellar malalignment.

 

If tightness in the lateral retinaculum is pulling your kneecap to the side, your doctor may recommend lateral release surgery to cut the ligament.

Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

Tibial Tubercle Transfer. In some cases, it may be necessary to realign the kneecap by moving the patellar tendon along with a portion of the tibial tubercle—the bony prominence on the tibia (shinbone).

A traditional open surgical incision is required for this procedure. The doctor partially or totally detaches the tibial tubercle so that the bone and the tendon can be moved toward the inner side of the knee. The piece of bone is then reattached to the tibia using screws. In most cases, this transfer allows for better tracking of the kneecap in the trochlear groove.