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Oxford University Hospitals NHS Foundation Trust
Hip and Knee

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Patellofemoral problems

Problems with the patellofemoral joint primarily concern stability and/or tracking of the knee cap within the groove on the front of the thigh bone.

Problems may occur due to any combination of the following factors:

  • tight tissues on the outside aspect of the thigh (ITB)
  • a poorly positioned and weak thigh muscle on the inner aspect of the knee (VMO)
  • a torn or stretched ligament connecting the knee cap to the thigh bone (medial patellofemoral ligament)
  • a muscle pull out of line due to rotational problems in the bones
  • abnormalities in development of the knee cap and the corresponding groove it sits in on the front of the thigh bone (trochlea dysplasia).

Tightness tends to lead to maltracking, excess pressure and wearing of the bearing surfaces leading to pain. Looseness tends to cause maltracking, instability and giving way.