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Patellofemoral smärta

Senast uppdaterad: Senast reviderad:
Sakkunnig:
Definition:
Smärttillstånd omkring eller bakom knäskålen.
Förekomst:
Mycket vanligt tillstånd, särskilt under tonåren fram till 30-års ålder. Kvinnor drabbas oftare än män. 
Symtom:
Vanligen värk omkring eller bakom knäskålen som tilltar av viktbelastning med böjt knä eller långvarigt böjt knä.
Kliniska fynd:
Felställningar och strama muskler kan predisponera för tillståndet. Frånvaro av smärta vid knäböjningar talar emot tillståndet.
Diagnostik:
Diagnosen baseras på anamnes och kliniska fynd.
Behandling:
I det akuta skedet rekommenderas relativ vila, eventuellt nedkylning och/eller NSAID. Senare rekommenderas fysioterapeutiska övningar. 
  1. Crossley KM, Stefanik JJ, Selfe J, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. Br J Sports Med. 2016;50(14):839-843. PMID:27343241. PubMed  
  2. Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019;99(2):88-94. PMID:30633480. PubMed  
  3. Smith BE, Selfe J, Thacker D, et al. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One. 2018;13(1):e0190892. PMID:29324820. PubMed  
  4. Glaviano NR, Kew M, Hart JM, Saliba S. DEMOGRAPHIC AND EPIDEMIOLOGICAL TRENDS IN PATELLOFEMORAL PAIN. Int J Sports Phys Ther. 2015;10(3):281-290. PMID:26075143. PubMed  
  5. Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med 2008; 7: 9.
  6. Feller JA, Amis AA, Andrish JT et al. Surgical biomechanics of the patellofemoral joint. Arthroscopy 2007; 23: 542-53.
  7. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther 2003; 33: 639-46.
  8. Cowan SM, Crossley KM, Bennell KL. Altered hip and trunk muscle function in individuals with patellofemoral pain. Br J Sports Med 2009; 43: 584-8. www.ncbi.nlm.nih.gov  
  9. Ireland M, Willson J, Ballantyne B et al. Hip strength in females with and without patellofemoral pain. J Orthop Sports Phys Ther 2003; 33: 671-6.
  10. Bump JM, Lewis L. Patellofemoral Syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 24, 2020. PMID:32491589. PubMed  
  11. Collins NJ, Barton CJ, van Middelkoop M, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018;52(18):1170-1178. PMID:29925502. PubMed  
  12. Dutton RA, Khadavi MJ, Fredericson M, et al. Patellofemoral Pain. Phys Med Rehabil Clin N Am. 2016; 27: 31-52. pmid:26616176 PubMed  
  13. Saltychev M, Dutton RA, Laimi K, Beaupré GS, Virolainen P, Fredericson M. Effectiveness of conservative treatment for patellofemoral pain syndrome: A systematic review and meta-analysis. J Rehabil Med. 2018;50(5):393-401. PMID:29392329. PubMed  
  14. van der Heijden RA, Lankhorst NE, van Linschoten R, et al. Exercise for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015 Jan 20;1:CD010387. PMID: 25603546. PubMed  
  15. Manojlovic D, Kozinc Z, Sarabon N Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis. J Pain Res. 2021. PMID: 34079359 PubMed  
  16. Kooiker L, Van De Port IG, Weir A, et al. Effects of physical therapist-guided quadriceps-strengthening exercises for the treatment of patellofemoral pain syndrome: a systematic review. J Orthop Sports Phys Ther. 2014 Jun;44(6):391-B1. PMID: 24766358. PubMed  
  17. Smith TO, Drew BT, Meek TH, Clark AB. Knee orthoses for treating patellofemoral pain syndrome. Cochrane Database Syst Rev. 2015;(12):CD010513. DOI:10.1002/14651858.CD010513.pub2. DOI  
  • Remy Waardenburg, specialist i allmänmedicin, medicinsk redaktör Medibas

Tidigare sakkunniga

  • Katarina Lönn, specialistläkare, Verksamhetsområde ortopedi, Akademiska sjukhuset, Uppsala