Patellar disorders.
Patellar disorders are common and painful. Although in many cases no precise cause for the pain is identified, poor patellar tracking, leading to imperfect distribution of forces in the patello-femoral joint, is a frequent finding. Tightness of the lateral retinaculum or anatomic predisposition for lateral tracking (e.g., femoral anteversion or an elevated Q angle) also places patients at increased risk for patellar pain. Most patients with patellar disorders will improve with simple programs of activity modification, therapy, and other nonsurgical modalities. Nonoperative therapy can include short arc quadriceps strengthening and stretching regimens, the application of ice, and the use of knee sleeves. Surgical treatment spans a wide range of choices, each tailored to specific diagnoses. These operations are reserved only for patients for whom conservative measures fail.
Bernstein
J
J
Sports Medicine Service, Hospital of the University of Pennsylvania Veterans' Hospital, Philadelphia, Pennsylvania 19104-6081, USA. orthodoc@mail.med.upenn.edu