Could My Knee Pain be Patellofemoral Arthritis?
Patellofemoral arthritis affects the underside of the kneecap (patella) and a groove in the thigh bone (femur) where the patella rests. It causes knee pain in the front of the knee, and if left untreated, it may result in chronic knee pain and limit your activities. It becomes difficult and painful to kneel, squat, climb and descend stairs.
The patella is a small bone located in front of the knee joint, where the femur and shinbone (tibia) meet. It protects your knee and connects the muscles in the front of your thigh to your tibia. The patella rests in an indented channel on top of the femur called the trochlear groove. When you bend and straighten your knee, the patella moves back and forth along this groove.
A slippery substance called articular cartilage covers the ends of the femur, trochlear groove, and underside of the patella. Articular cartilage is what allows the bones to glide smoothly against one another as the leg moves.
Knee pain from patellofemoral arthritis occurs when the articular cartilage along the trochlear groove and on the underside of the patella wears down and becomes inflamed.
When the cartilage wears away, the underlying bone may become exposed. The resulting chronic knee pain comes from the bones rubbing against each other along this rough surface.
Symptoms of Patellofemoral Arthritis
The primary symptom of patellofemoral arthritis is chronic knee pain, often at the front of the knee. This knee pain usually begins with movement, however, there may also be pain while resting. Activities that pressure the kneecap, such as climbing stairs, kneeling, or getting up from a chair can accentuate this pain.
Other symptoms of patellofemoral arthritis may include:
● Stiffness
● Swelling
● A creaking or crackling sensation in the knee, known as crepitus.
When this condition becomes advanced, your kneecap may get stuck, or catch, when you straighten your knee.
Typically is difficult to the patients use the stairs
Causes of Patellofemoral Arthritis
Doctors aren’t certain what causes patellofemoral knee pain syndrome, but it’s been commonly associated with:
- Overuse. Running or jumping sports put repetitive stress on your knee joint, which can cause irritation under the kneecap.
- Muscle imbalances or weaknesses. Patellofemoral pain can occur when the muscles around your hip and knee don’t keep your kneecap properly aligned. Inward movement of the knee while squatting has been associated with patellofemoral knee pain.
- Injury. Trauma to the kneecap, such as a dislocation or fracture, has been linked to patellofemoral knee pain syndrome.
- Surgery. Knee surgery, particularly surgery that uses the patellar tendon to repair the anterior cruciate ligament. This was found to increase the risk of experiencing patellofemoral knee pain.
Prevention of Patellofemoral Arthritis
Anyone can suffer from knee pain, but there are steps you can take towards prevention.
- Maintain strength. Strong quadriceps and hip abductor muscles help keep the knee balanced during activity. However, it is advised to avoid deep squatting during weight training.
- Alignment and technique. Ask your doctor or physical therapist about flexibility and strength exercises that optimize your jumping, running and pivoting techniques. This helps the patella to move properly along the trochlear groove. Moreover, it is especially important to exercise your outer hip muscles. This prevents your knee from caving inwards when you squat, land from a jump or step down off an elevated surface.
- Weight Management. Excess weight puts additional pressure on the knee and can speed up the natural wear and tear of the joint.
- Warm up. Before running or performing other strenuous exercises, warm up for five minutes or so with light activity to prepare the knee and reduce the risk of injury.
- Stretching. Promote flexibility with gentle stretching exercises.
- Workout intensity. When exercising, try to avoid sudden changes to your routine and introduce higher intensity training gradually.
- Wear well-fitted shoes. Make sure your shoes fit your feet well and provide good shock absorption. If you have flat feet, consider investing in shoe inserts to protect your knees.
Treatment of Patellofemoral Arthritis
Physiotherapy
A physiotherapist might suggest some of the following:
- Rehabilitation exercises. Specific exercises can strengthen the muscles that support your knees and control limb alignment. Correcting inward movement of the knee during squatting is the primary goal.
- Knee Braces. Knee braces or arch supports may help improve knee pain.
- Taping. Your physical therapist may show you how to tape your knee to reduce pain and enhance your ability to exercise.
- Ice. Icing your knee after activity might be helpful.
- Knee-friendly sports. During your recovery, you may want to restrict yourself to low-impact sports that are easier on the knees. Avoid jumping sports, hill running and full squates.
Regenerative Therapies
Your knee pain might be severe enough that it is stopping you from getting out or playing sports. In that case, minimally invasive regenerative treatments is a viable alternative to irreversible knee replacement surgeries.
Bone Marrow Aspirate Concentrate (BMAC)
Bone Marrow Aspirate Concentrate (BMAC) is a non-surgical, minimally invasive, regenerative treatment. It harnesses the body’s inbuilt capacity to heal through the assistance of naturally secreted biological growth factors. BMAC utilises mesenchymal stem cells collected from the bone marrow to aid in accelerating the healing of moderate to severe osteoarthritis and tendon injuries.
Mesenchymal stem cells (MSCs) are a multipotent subgroup of stem cells that can develop into a variety of cells and tissues. Yellow bone marrow-derived from mesenchymal stem cells (BMSCs) display a higher capacity to form bone and cartilage compared to MSCs derived from adipose tissue.
Results of this treatment may vary with individual patients and it is difficult to determine the level of success before performing the procedure.
At the sight of an injury, BMSCs secrete very high concentrations of tissue and cell-specific substances that support, maximize and direct self-repair and regeneration. These natural chemicals have an anti-inflammatory role. They modify the immune response of the body. This blocks the inflammatory pathways, produces anti-inflammatory macrophages and increases anti-bacterial activity to provide long-term pain relief.
At Regenecare, we believe that Surgery should only be considered after less invasive non-surgical treatments have been explored. It is important to note that surgical procedures have many risks attached to them. Furthermore, they require long and extensive rehabilitation.
What is the next step?
The most important part of any treatment is a proper diagnosis.
Dr Gehad El Bastawisy, a Pain Management Specialist with 30 years of experience, was the first doctor to introduce regenerative medicine for pain management in Ireland. On arrival at one of our clinics in Cork, Dublin, or Cavan, Dr Gehad will perform a full physical examination of the knee to diagnosis or exclude patellofemoral arthritis. If necessary, a diagnostic scan such as an X-Ray or an MRI will be requested. Dr Gehad will then draft a treatment plan that is specialised to your individual case and condition in order to provide you with the most pain relief possible.
Book an appointment with Dr Gehad and take the first step of your treatment journey. We also encourage you to listen and read through our patient testimonials where some of our previous patients share their experience with Regenecare Pain Management Clinics: