Patello Femoral Problems (Kneecap)

Anterior knee pain (Chondromalacia patella) is a condition usually found in females in their late teens and early twenties.
The underlying problem is not fully understood and may be multifactorial.
The abnormality appears to be some softening of the cartilage under the kneecap, which is less tolerant of load and causes pain.
There is usually no damage or major problem found within the knee and surgery is of no benefit except in diagnosing the condition.
Treatment depends on modifying activities and avoiding excess loading of the kneecap combined with physiotherapy exercises for knee pain and most cases self resolve over a period of time with intermittent exacerbations and episodes along the way.
A chondromalacia patella knee brace with lateral stabilisers is sometimes beneficial
Occasionally anterior knee pain is on account of an overuse tendinitis seen in runners and is called runners knee. Physical therapy runners knee (eccentric exercise program) and activity modification usually improve this condition

Recurrent dislocation of the kneecap can be a very complex problem in terms of cause and treatment.
It requires a thorough understanding of the biomechanics and forces going across the knee and an assessment of any predisposing factors in the patient.
Treatment is very variable from physiotherapy exercises for knee pain and PFJ, patella knee bracing, or surgery and results are less predictable than in other areas of knee surgery.

Maltracking of the kneecap is usually a result of an imbalance between forces displacing the kneecap and muscle counteracting forces to stabilise it.
Treatment usually is directed at correcting muscle strength in the appropriate muscles to reduce the imbalance. Physiotherapy exercises for knee pain and targeting the VMO muscle (Vastus Medialis Obliqe) are effective but need performing over a long period.
A chondromalacia patella knee brace with lateral stabilisers can also sometimes help.