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Lateral Patellar Compression Syndrome1

Patella Anatomy

The patella, also called kneecap, is a small flat triangular bone located at the front of the knee joint. It is a sesamoid bone embedded in a tendon that connects the muscles of the thigh to the shinbone (tibia). The function of the patella is to protect the front portion of the knee.

What is Lateral Patellar Compression Syndrome?

Lateral patellar compression syndrome refers to pain under and around your kneecap. It is a common complaint among runners, jumpers and other athletes such as skiers, cyclists, and soccer players. 

Causes of Lateral Patellar Compression Syndrome

Lateral patellar compression syndrome can result from poor alignment of the kneecap, complete or partial dislocation, overuse, tight or weak thigh muscles, flat feet and direct trauma to the knee. 

Symptoms of Lateral Patellar Compression Syndrome

Pain is the predominant symptom and is usually gradual in onset. You may experience a dull aching pain around the sides, below or behind the kneecap. Sometimes, climbing stairs and standing up or walking after prolonged sitting may produce a popping or cracking sound in the knee. The pain may also be present at night and be exaggerated by any repetitive knee bending activity such as jumping, squatting, running or weight lifting. 

Diagnosis of Lateral Patellar Compression Syndrome

To diagnose lateral patellar compression syndrome, your doctor will review your symptoms, medical history, and inquire about your sports participation and activities that are likely to aggravate your knee pain. Further to this, your doctor will perform a physical examination of your knee. Diagnostic imaging tests such as X-rays, MRIs, and CT scans may be ordered to determine if your pain is due to damage to the structure of the knee or because of the tissues that attach to it.

Treatment of Lateral Patellar Compression Syndrome

The initial treatment is to avoid activities such as running and jumping, which can cause pain. Treatment options include both non-surgical and surgical methods. Non-surgical treatment consists of rest, ice, compression and elevation (RICE protocol); all assist in controlling pain and swelling. Non-steroidal anti-inflammatory medications may be prescribed to reduce pain.

Other non-surgical treatments include:

  • Exercises: Your doctor may recommend an exercise program to improve the flexibility and strength of the thigh muscles. Cross-training exercises to stretch the lower extremities may also be recommended by your doctor.
  • Knee taping: An adhesive tape is applied over the patella, to alter the kneecap alignment and movement. Taping of the patella may reduce pain.
  • Knee brace: A special brace for the knee may be used during sports participation, which may help reduce pain.

If symptoms persist, a lateral retinacular release may be performed. In this procedure, the tight ligaments on the outer side of the knee are released, allowing the patella to sit properly in the femoral groove. Your surgeon may also tighten the tendons on the inside or medial side of the knee to realign the quadriceps.