Diagnosis and Management of Patellofemoral Cartilage Injuries (2023 Annual Meeting)-Evaluation and Non-Surgical Treatment for Patellofemoral Chondral Lesions

Evaluation and Non-Surgical Treatment for Patellofemoral Chondral Lesions

Video Transcription

Video Summary

Dr. Drew Lansdowne discusses the diagnosis and nonoperative treatment of patellofemoral cartilage lesions, which are common and often seen during arthroscopy, especially in younger patients. Anterior knee pain, a frequent complaint, can have multiple causes, making accurate diagnosis crucial. The patellofemoral joint's unique anatomy and biomechanics complicate treatment. Lesions typically arise from traumatic events, like dislocations causing medial facet injury, or from chronic maltracking leading to microtrauma. Evaluation includes a detailed history emphasizing mechanical symptoms and swelling, physical exams assessing effusion, patellar tracking, and functional strength via single-leg squats. Imaging entails weight-bearing radiographs and MRI, noting that MRI underestimates lesion size. Non-surgical management, the first-line approach, involves activity modification, NSAIDs, injections, and especially targeted physical therapy focusing on hip and knee strengthening; blood flow restriction therapy shows promise. Debridement (chondroplasty) may help with mechanical symptoms and occasionally suffices. Overall, individualized assessment is key for effective, mostly nonoperative care of patellofemoral cartilage injuries.

Asset Caption

Drew Lansdown, M.D.

Keywords

patellofemoral cartilage lesions

anterior knee pain

nonoperative treatment

physical therapy

MRI imaging