Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA.
Am Fam Physician. 2019 Jan 15;99(2):88-94.
Patellofemoral pain syndrome (PFPS) is one of the most common causes of anterior knee pain encountered in the outpatient setting in adolescents and adults younger than 60 years. The incidence in the United States is between 3% and 6%. The cardinal feature of PFPS is pain in or around the anterior knee that intensifies when the knee is flexed during weight-bearing activities. The pain of PFPS often worsens with prolonged sitting or descending stairs. The most sensitive physical examination finding is pain with squatting. Examining a patient's gait, posture, and footwear can help identify contributing causes. Plain radiographs of the knee are not necessary for the diagnosis of PFPS but can exclude other diagnoses, such as osteoarthritis, patellar fracture, and osteochondritis. If conservative treatment measures are unsuccessful, plain radiography is recommended. Treatment of PFPS includes rest, a short course of nonsteroidal anti-inflammatory drugs, and physical therapy directed at strengthening the hip flexor, trunk, and knee muscle groups. Patellar kinesiotaping may provide additional short-term pain relief; however, evidence is insufficient to support its routine use. Surgery is considered a last resort.
髌股疼痛综合征（PFPS）是青少年和 60 岁以下成年人在门诊中最常见的前膝痛原因之一。在美国，其发病率在 3%至 6%之间。PFPS 的主要特征是在负重活动时膝盖弯曲时出现前膝或周围疼痛，疼痛加剧。PFPS 的疼痛常因长时间坐着或下楼梯而加重。最敏感的体格检查发现是下蹲时疼痛。检查患者的步态、姿势和鞋子可以帮助确定促成因素。髌股疼痛综合征的诊断不需要膝关节的普通 X 线片，但可以排除其他诊断，如骨关节炎、髌骨骨折和骨软骨炎。如果保守治疗措施无效，建议进行普通 X 线片检查。PFPS 的治疗包括休息、短期非甾体抗炎药治疗和针对加强髋关节屈肌、躯干和膝关节肌肉群的物理治疗。髌股运动贴可能提供额外的短期疼痛缓解；然而，证据不足以支持其常规使用。手术被认为是最后的手段。
