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CONTACT US
Gobezie, Reuben, MD
Chief, Division of Shoulder & Elbow Surgery
Case Western Reserve University School of Medicine
University Hospitals of Cleveland
Phone Numbers
Appointments: (216) 844-7200
Office Number: (216) 844-7093
FAX Number: (216) 844-5970
Email: rgobezie@gmail.com
Office Locations
UHHS Chagrin Highlands Medical Center
3909 Orange Place
Orange Village, OH 44122
County: Cuyahoga-East
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office
University Suburban Health Center
1611 S. Green Road
South Euclid, OH 44121
Phone Number: (216) 844-7093
Fax Number: (216) 844-5970
Directions To Our Office
University Hospitals
Westlake Campus
960 Clague Road
Westlake, OH
Directions To Our Office
UHHS Bedford Medical Center
44 Blaine Ave
Cleveland, OH 44146
Phone Number:(216) 844-7093
Directions To Our Office
8819 Commons Boulevard
Twinsburg, OH 44087
Phone Number:(216) 844-7093
Directions To Our Office
University Hospitals Mentor
9000 Mentor Ave
Mentor, OH
Directions To Our Office
UH Richmond Medical Center
27100 Chardon Rd
Richmond Hts, OH 44143
Phone: (216) 844-7093
Fax: (216) 844-5970
Directions To Our Office
UH Concord Health Center
7500 Auburn Rd
Concord, OH 44077
Directions To Our Office
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 Patellofemoral
pain syndrome (PFPS) is a common knee disorder, which often affects
the senior athlete and those involved in running and jumping sports.
Overuse, a change in activity, and an altered metabolic status are
frequently responsible for the development of PFPS. Structural alignment
and muscular weakness or imbalance may cause the patella
(kneecap) to track improperly on the femur (thigh bone)
during movement, leading to pain around the kneecap.
Other terms for patellofemoral pain are: retropatellar pain, peripatellar
pain, anterior knee pain, and runner's knee.
Different disorders that cause pain around the kneecap include:
- infrapatellar tendonitis (jumper's knee), which
affects the tendon just below the kneecap
- chondromalacia patella, which involves damage
to the cartilage surface of the patella
- quadriceps tendonitis, which affects the tendon
attachment above the patella
- plica syndrome, in which joint tissue becomes
inflamed and/or stiff, causing pain and tightness in the joint
Click here to read more about knee structure.
What is the patellofemoral joint?
As the knee bends and straightens, the patella slides within a slot
on the femur called the trochlear groove. The patella
moves in many directions within this groove to provide efficient,
frictionless movement up and down, side-to-side, rotational, and tilting.
The bone surfaces are covered with articular cartilage
to make joint movement smooth.
What is patellofemoral pain syndrome and what can cause it?
Repeated abrasion on any of the surfaces of the patella and femur
stresses the soft tissues of the patellofemoral joint and may even
lead to a bone bruise. In some cases, the pain is caused by a weakening
of the articular cartilage and/or swelling within the joint.
One or more of the following factors can lead to patellofemoral pain:
- Overuse: the repetitive bending and straightening of
the knee that occurs in running may lead to the disorder because
of the increased pressure points between the patella and femur
when the knee is bent. A constant bending motion, especially on
the weighted leg, can irritate the patella and cause a bone bruise
to form.
- Alignment: The quadriceps alignment between the hip
and the knee (the
Q angle) is thought to affect patellar tracking. Patients
with a larger than normal Q angle (greater than 20 degrees) may
be more susceptible to patellofemoral pain because the patella
has a tendency to track more laterally (to the outside).
Pain may be felt more on the outside of the patella and femur
because of increased pressure on these contact areas. The Q
angle of growing female athletes enlarges as the pelvis widens
during the maturing process, increasing the risk for patellofemoral
pain.
- Muscular weakness: A weakness or strength imbalance of
the quadriceps muscles may alter the tracking of the patella.
- Muscular tightness: Tight muscles and tendons may also
affect patellar tracking. The muscular structures that cause movement
in the knee and hip must be flexible. If any one muscle or
muscle group is tighter than the rest, patellar instability can
occur.
- Flat feet (excessive foot pronation): Patients
with little or no arch in the foot are also likely candidates
for patellofemoral pain. As the foot rolls inward, the tibia compensates
by rotating inward, disturbing the normal mechanics of the patellofemoral
joint.
- A decrease in patellar mobility: the kneecap tightens,
losing its normal ability to move in many directions.
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