Recently, Dr. Andreas Gomoll (my husband) and I joined the Braun Performance & Rehab Podcast to discuss the patellofemoral joint in detail and address specific considerations related to patellofemoral instability, cartilage defects, and other relevant topics.
Patellofemoral Pain Syndrome and Instability
Patellofemoral pain syndrome is often diagnosed without a thorough investigation into the underlying causes. This can lead to oversimplification, where conditions like patellar instability are treated solely with medial patellofemoral ligament (MPFL) reconstruction. However, MPFL is primarily for addressing instability rather than pain. Other factors, such as cartilage defects, patella alta (high-riding patella, where the patella sits high on the femur), and dysplasia, must be considered for pain treatment.
Cartilage Defects and Treatment Options
Cartilage defects are common in both ACL injuries and patellofemoral instability. While minor defects may not be symptomatic, larger ones do require attention. Treatments include osteochondral autograft transplantation (OATS) and osteochondral allograft (OCA) procedures. The choice between single and multi-plug techniques depends on the defect’s shape and size. Multi-plug methods are used for larger, more complex defects.
Rehabilitation and Recovery
For the best recovery outcomes, you need a motivated patient, a good surgeon, and a great physical therapist. Early mobilization, blood flow restriction, and appropriate physical therapy are also important for recovery. One of the reasons your surgeon’s skills are so important is that they can minimize tissue disruption (smaller incisions) during surgery, which also aids in quicker recovery.
And, of course, the relationship between the patient and their physical therapist is vital, especially for younger patients. It’s really important to get younger patients, who are used to being very active, to buy into physical therapy as part of the recovery process.
Listen to the rest of our discussion on the Braun Performance and Rehab Podcast. The image is from the podcast page.