Konservative Behandlungs-Strategien ­patellofemoraler Beschwerden in der Physiotherapie

A common complaint in the musculoskeletal system is the anterior knee pain (AKP) or the so called patellofemoral pain syndrome (PFPS). The large number of contributing factors that lead to the symptoms make a proper diagnosis and targeted physiotherapeutic treatment management difficult. With regard to symptom-complex-oriented physiotherapeutic care, the question arises as to which therapy methods should be used for individuals with AKP. In order to be able to identify adequate physical therapy methods, an understanding of the clinical condition and the chosen treatment method is essential. This article aims to present a heuristic model of objectives and situational physiotherapeutic treatment methods.

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Übungsempfehlungen bei patellofemoralen ­Kniebeschwerden

Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.

Continue ReadingÜbungsempfehlungen bei patellofemoralen ­Kniebeschwerden

Patellar instability

Lateral patellar dislocation (PD) has multifactorial origin. Its treatment will depend on the physical demands of the patient, triggering event and injury mechanism of PD, number of dislocation episodes, patellofemoral joint morphology, and concomitant injuries. After primary PD, despite the risk of recurrence being 33-77%, first treatment option is mostly conservative, except if an osteochondral fragment needs to be refixed or removed.

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What sports medicine practitioners should know about imaging for femoro-patellar pathologies

Clinical imaging in patellofemoral disorders is fundamental for the understanding of the pathology, and to find the adequate treatment option. Anatomical risk factors such as trochlear dysplasia, patella alta, lateralized tibiale tubercle (measured by the tibiale tubercle trochlear groove distance), torsional or coronal lower limb alignment that are the origine of patellar maltracking or even patellar dislocation, can be assessed with high reliability on conventional radiographs combined with MR imaging.

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Physical examination of the patellofemoral joint

Patients with a patellofemoral pain are either in an acute state after a patellofemoral dislocation or are suffering from a chronic anterior knee pain (AKP), whereas AKP might be accompanied by patellar instability without dislocation. Whereas the acute state after a dislocation is mostly clear and its examination limited, the examination of a AKP is much more complex. A profound knowledge of the anatomy, the painful structures and patellofemoral biomechanics is essential in order to find the underlying pathology within the heterogeneous and diverse etiologies. Furthermore, a meticulous and precise examination is key to find the adequate treatment for AKP.

Continue ReadingPhysical examination of the patellofemoral joint