What are the other Names for this Condition? (Also known as/Synonyms)

• Arthritis of the Kneecap
• Inflammation of the Kneecap
• Kneecap Arthritis 

What is Patellofemoral Arthritis? (Definition/Background Information)

• Arthritis is a joint disorder characterized by an abnormal inflammation that affects one or more joints, within the body. Generally, arthritis increases with age. The majority of individuals who develop the condition begin experiencing pain and stiffness, in the affected joint or limb
• Patellofemoral Arthritis (or Arthritis of the Kneecap) is characterized by an abnormal inflammation that affects the joint within the kneecap

There are several different types of arthritis based upon the cause. The most common types of Patellofemoral Arthritis that may develop include:

• Degenerative Osteoarthritis of Kneecap: It is the most common type of arthritis. Osteoarthritis is characterized by a progressive degeneration of cartilage, bones, or synovial membrane, within the joint, usually over a prolonged time period
• Post-Traumatic Kneecap Arthritis: Post-traumatic arthritis is also a progressive, degenerative disorder that may develop after any significantly traumatic injury. It is a type of osteoarthritis
• Rheumatoid Arthritis involving Kneecap: Rheumatoid arthritis is an autoimmune, systemic, inflammatory condition that may affect the lining of joints, surrounding tissues, or organs, within the body
• Systemic Lupus Erythematosus causing Kneecap Arthritis: Systemic lupus erythematosus (SLE) is an autoimmune systemic inflammatory condition that occurs when an individual’s immune system creates antibodies that accidently attack healthy tissues and organs within the body
• Gout involving the Kneecap: A complex type of inflammatory arthritis, gouty arthritis is a medical condition caused by a high level of uric acid in blood. A gout attack occurs with the abnormal formation of crystallized uric acid, resulting in inflammation of the joints. Gout generally affects small joints of the foot. Involvement of the knee joint by gout is not common 

Who gets Patellofemoral Arthritis? (Age and Sex Distribution)

• Individuals of all age, race, or ethnic groups, and belonging to any gender, may develop Patellofemoral Arthritis
• However, a high percentage of individuals, who develop Kneecap Degenerative Arthritis causing a debilitating and progressive disorder, are middle-aged and elderly adults
• Young athletes, who sustain traumatic joint injuries while participating in rough or high-impact sports, may develop Post-Traumatic Kneecap Arthritis 

What are the Risk Factors for Patellofemoral Arthritis? (Predisposing Factors)

Risk factors associated with Patellofemoral Arthritis include:

• Age: Patellofemoral Arthritis may develop in individuals of all ages, but is rarely diagnosed in individuals under the age of 40 years. However, since it is a gradual progressive disorder, the risk of developing this condition usually increases with age
• Gender: Women have an increased risk of developing this type of arthritis
• Athletics: Individuals, who sustain a fractured kneecap while participating in a rough or high-impact sport, such as football, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding, are prone to developing Post-Traumatic Kneecap Arthritis
• Obesity: Excess body weight associated with obesity may cause abnormally increased pressure on the joints. This increases the risk for degenerative osteoarthritis, affecting the kneecap
• Certain occupations: Individuals with certain occupations, which require a set of repetitive physical movement/motion for prolonged periods, have an increased risk of developing Degenerative Osteoarthritis of the Kneecap
• Rheumatoid arthritis: Individuals, who develop rheumatoid arthritis, are at an increased risk
• Gout: Gout is a complex type of inflammatory arthritis that increases one’s risk of developing Patellofemoral Arthritis
• Paget’s disease of bone: Individuals with Paget’s disease of bone, a rare chronic bone disorder characterized by abnormal growth and deformity of bones
• Other conditions that increase one’s risk of Kneecap Arthritis include septic arthritis and dysplasia

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Patellofemoral Arthritis? (Etiology)

Many different contributing factors exist, since there are several different types of arthritis. Some causes that may be associated with Arthritis of the Kneecap include:

• Sports-related injury: Individuals, who sustain a kneecap fracture, while participating in rough or high-impact sports, such as football, basketball, soccer, wrestling, rugby, hockey, skiing, and snowboarding
• Certain occupations: Individuals with certain occupations that require a set of repetitive physical movement/motion for prolonged periods, such as carpenters and painters, may be affected by Degenerative Osteoarthritis of the Kneecap
• Family history: Some arthritic disorders, such as rheumatoid arthritis, have a genetic prevalence. Those having an immediate family member or a relative with a history of this condition may be at risk
• Obesity: Excess body weight associated with obesity, may cause abnormally increased pressure on the joints
• Dysplasia: Dysplasia (developmental abnormality) may be a cause for the development of Patellofemoral Arthritis 

What are the Signs and Symptoms of Patellofemoral Arthritis?

Arthritis is a gradual and progressive disorder that usually worsens over time. Common signs and symptoms associated with Patellofemoral Arthritis include:

• Noticeable pain and tenderness (pain on touch)
• Stiffness, decreased range of motion of the knee joint
• Formation of bone spurs surrounding the knee joint
• Noticeable redness, due to an inflammatory response of the body 

How is Patellofemoral Arthritis Diagnosed?

Common tests and exams a physician may use to help diagnose Patellofemoral Arthritis (or Kneecap Arthritis) include:

• Physical examination: A thorough physical examination of the knee may be undertaken by the physician. In addition to this, a complete medical history will aid in arriving at the correct cause of Kneecap Arthritis
• X-rays of the knee joint: X-rays use radiation to produce images of the kneecap/knee joint. It can help the physician rule out other possible causes for knee discomfort
• Blood Test: A blood sample is drawn from an artery or vein using a needle and taken to a laboratory for analysis. Blood tests, such as complete blood count (CBC), rheumatoid factor (RF) levels, cultures of the joint fluid, lupus blood tests (SLE panel) help the healthcare provider arrive at a cause for Kneecap Arthritis
• Fine needle aspiration (FNA) of joint fluid analysis: Occasionally, fluid may accumulate around a joint, which results in pain and disability. Analysis of this joint fluid will provide clues regarding the cause of joint fluid accumulation, which results in pain and disability
• Ultrasound imaging: An ultrasound imaging equipment uses high-frequency sound waves to generate a more detailed image of the knee
• CT scan of the knee joint
• MRI scan of the knee joint

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Patellofemoral Arthritis?

Arthritis is a progressive condition that gradually worsens over a long period of time. The complications from Patellofemoral Arthritis include:

• Chronic pain and stiffness within the knee joint, which may prevent individuals from performing their routine daily activities
• Some cases may cause permanent disability (frozen joints) 

How is Patellofemoral Arthritis Treated?

The treatment measures depend on the cause of Patellofemoral Arthritis and these are grouped as non-surgical and surgical treatment methods. A healthcare provider may start with non-surgical treatment methods before adopting surgical procedures and techniques. However, in some cases, the healthcare provider may elect to use surgical treatment methods, if the symptoms or the condition, cannot be managed with conservative non-surgical methods. 

Nonsurgical treatment measures that may help relieve pain and improve range of motion of the knee joint include: 

• Rest: Any activity that aggravates the knee condition further should be avoided. The physician usually advises individuals to refrain from all such activities, until the symptoms improve
• Heat and ice: Applying a damp heated towel or ice to the knee joint, can help reduce pain and swelling
• Splint or brace: Some type of padded splint or cast may be used to help keep the knee joint in a stable position, especially while sleeping
• Non-steroidal anti-inflammatory medication: Oral medications, such as ibuprofen and naproxen, can help decrease pain and swelling in the knee
• Corticosteroids: Oral steroidal medications, such as prednisone, may help decrease inflammation and increase the motion range of the knee
• Viscosupplementation therapy: The normally present fluid (synovial fluid) within a joint contains a material called hyaluronic acid. When a joint is affected by osteoarthritis, there is a reduction of hyaluronic acid level within the joint. This decreased acid level reduces the fluid’s ability to lubricate the joint. Viscosupplementation is a common and minimally invasive technique that is used in treating osteoarthritis. During this procedure, small doses of hyaluronic acid are injected into the knee joint, to increase its lubrication and thereby relieve pain
• Physical therapy: After the signs and symptoms have decreased, it is important to begin some light motion exercises. Physical therapy may help restore strength, as well as flexibility, in the muscles 

Surgical treatment measures for Kneecap Arthritis include:

• Cartilage grafting: Cartilage grafting is a surgical intervention technique that involves replacing lost cartilage within the knee joint, which may be damaged due to an arthritic disorder or a traumatic injury
• Patellofemoral replacement: Patellofemoral replacement is a surgical intervention technique that involves the removal of a part of the knee joint. This surgical procedure is recommended, if arthritis is limited to a certain area of the knee. The arthritic part of the knee is removed and replaced by a prosthetic implant
• Total knee arthroplasty: In total knee arthroplasty, the knee joint cartilage is completely removed. It is then replaced by a metal and plastic prosthetic implant. This surgical procedure is recommended, if the entire knee joint is acutely affected by the inflammatory and degenerative joint disorder
• Arthroscopic chondroplasty: Arthroscopic chondroplasty is a surgical intervention technique that involves repairing damaged cartilage within the knee; thus allowing the growth of healthy tissue in its place. This surgical procedure is performed using an orthopedic device, called an arthroscope, and is useful in treating mild to moderate Patellofemoral Arthritis 

How can Patellofemoral Arthritis be Prevented?

Common recommendations to help prevent Patellofemoral Arthritis include:

• Healthy body weight: Maintaining a healthy body weight can help reduce abnormal pressure on the joints, which may decrease the risk of arthritis
• Healthy diet: Individuals who consume a healthy diet regularly, may decrease their chances of developing Kneecap Arthritis 
• Use protective gear: Individuals, who participate in high-risk sports activities (like football and ice hockey), should wear appropriate safety equipment to help prevent the possibility of injuring their knees, or other joints
• Regular stretching exercises can help in decreasing the incidence of Arthritis of the Knee development 

What is the Prognosis of Patellofemoral Arthritis? (Outcomes/Resolutions)

• The long-term prognosis of arthritis depends on the specific type of inflammatory and degenerative disorder an individual develops, and the severity of the condition
• If the cause of Patellofemoral Arthritis is detected early, and proper, aggressive treatment provided; then, the quality of life can be substantially improved. This also helps avoid any serious complications from arising in the knee joint
• Degenerative Osteoarthritis of the Kneecap is a debilitating disorder. A high percentage of patients who develop this disorder may experience a gradual degeneration of their knee joint, during their lifetime 

Additional and Relevant Useful Information for Patellofemoral Arthritis:

Fine needle aspiration (FNA) of joint fluid analysis procedure:

• A needle is inserted within the joint space and the accumulated fluid aspirated with a syringe, which is then sent to a laboratory for analysis
• The tests a laboratory may perform would include:  Analysis of the type of cells present in the fluid, chemical composition of the fluid, and examination of the fluid under the microscope, for the presence of crystals
• If an infection is suspected as the cause for fluid accumulation at the joint, then a joint fluid culture may be performed, to remove fluid from the joint 

One must be careful while adopting unproven and non-evidence based claims, such as copper bracelets and magnets, for treating joint disorders. Your healthcare provider is the best source for advice, on new methods of treatment.