The patellofemoral pain syndrome (PFPS) is a
possible cause for anterior knee pain, which predominantly
affects young female patients without any structural
changes such as increased Q-angle or significant chondral
damage. This literature review has shown that PFPS
development is probably multifactorial with various functional
disorders of the lower extremity. Biomechanical
studies described patellar maltracking and dynamic valgus
in PFPS patients (functional malalignment). Causes for the
dynamic valgus may be decreased strength of the hip
abductors or abnormal rear-foot eversion with pes pronatus
valgus. PFPS is further associated with vastus medialis/
vastus lateralis dysbalance, hamstring tightness or iliotibial
tract tightness. The literature provides evidence for a
multimodal non-operative therapy concept with short-term
use of NSAIDs, short-term use of a medially directed tape
and exercise programmes with the inclusion of the lower
extremity, and hip and trunk muscles. There is also evidence
for the use of patellar braces and foot orthosis. A
randomized controlled trial has shown that arthroscopy is
not the treatment of choice for treatment of PFPS without
any structural changes. Patients with anterior knee pain
have to be examined carefully with regard to functional
causes for a PFPS. The treatment of PFPS patients is nonoperative
and should address the functional causes.