Patellofemoral Pain and Trochlear Dysplasia

Patellofemoral knee pain and Trochlear Dysplasia are related and you can read more below.
Patellofemoral knee pain - also called anterior knee pain, is a symptom 

First of all is patellofemoral knee pain a symptom and not a disease. Trochlear Dysplasia means a shallow or flat groove for the kneecap. You might have an MRI that says trochlear dysplasia or dysplastic trochlea, which is the same. It is likely you have no symptoms from this. Nevertheless are a few patients troubled by severe chronic patellofemoral pain and trochlear dysplasia. Trochlear dysplasia increases the cartilage forces in the knee joint. What happens is that the cartilage contact area is too little. This gives high pressure on a little area. Some of these patient might be helped very well by a trochleoplasty surgery since the cartilage is unloaded. Read more on the page for anterior knee pain, the page for trochleoplasty and the page for trochlear dysplasia. It´s important to say that all types of Trochlear Dysplasia predispose to anterior knee pain and that there are several other factors that is involved in patellofemoral pain

Second opinion

Eventually get a second opinion from another patellofemoral surgeon - not just a standard orthopaedic surgeon. You are also welcome to book an online consultation with me for 175 euro prepaid. I need to see you MRI before the meeting. (contact me on [email protected]). Another solution is to accept the pain and reduce your level of activity to a lower level. The knee surgeon, Scott Dye, has for years spoken for the 'functional envelope'. This could be a solution for you. Eventually you can do some reading in the following special issue incl a paper from my hand.

Scientific evidence is slowly increasing

First I published a case report on arthroscopic trochleoplasty for chronic patellofemoral pain and trochlear dysplasia - link here. A new publication confirms that patients having chronic patellofemoral pain and trochlear dysplasia may benefit from a trochleoplasty - link here

An example

Left you see a axial view of a 36 year old women. She had severe anterior knee pain for 20 years. During her patellofemoral arthroplasty surgery there were no cartilage left in the patellofemoral joint. If she just have had a trochleoplasty when she was younger, this may have given her 20 years without pain and likely this soulc also have prevented the development of osteoarthritis

Chronic patellofemoral pain

Back in 1998 we did a follow-up on patients having anterior knee pain.We found, that about half of the patients continue to have light to moderate pain for years. About one out of 10 continues to have severe chronic pain. You can download a PDF copy here. Later have these findings been confirmed by several others. 

Is there a relationship between patellofemoral pain and patellofemoral arthritis?

The clinical entity called anterior knee pain (AKP) or patellofemoral pain (PFP) or chondromalacia patellae can leads to arthritis. This relationship has lately been revealed. It seems logic that some severely troubled patients ends up having arthritis. See the study from Conchie et al.