PFJ

Fat Pad Syndrome

Definition

 

Hoffa's syndrome

- impingement of the fat pad with knee ROM

 

Epidemiology

 

Rare

Diagnosis of exclusion

 

Theory

 

May be more prevalent in patients with intact ligamentum mucosum

 

Diagnosis

 

Hoffa's sign

- apply pressure to fat pad each side of patella tendon with knee in flexion

- extend knee

Background

Definition

Dislocated Patella

 

Repeated dislocation of patella with minimal trauma

- 15-20% of paediatric acute patella dislocations

- more common girls 

- often bilateral

 

Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion 

 

Direction

 

Management

Non-operativePatella Instability MPFL and TTT AP

 

Results

 

90% respond 

- very important

- 6 - 12 months minimum before offering surgery

 

Physiotherapy

 

1.  Stretches

- quads stretches

- ITB

- lateral retinaculum

 

Chondromalacia Patellae

Definition

 

Patella Chondromalacia

 

Softening and fibrillation of articular cartilage of patella

 

Problem

- softening and fibrillation often seen in asymptomatic population

- can have typical anterior knee pain without retro-patellar changes

 

Epidemiology

 

Female adolescent

- recent increase in activity

 

PFJ osteoarthritis

EpidemiologyPatella OA Medial Facet

 

1 in 10 patients with symptomatic knees have isolated PFJ OA

 

Aetiology

 

Obesity

Repetitive deep flexion

Malalignment

Lateral patella tightness

Blunt trauma

 

Symptoms

 

Anterior knee pain

- rising from chair