Abstract
Thirty patients, 13 skeletally immature individuals and 17 adults, participated in a prospective study designed to evaluate the effect of isometric quadriceps strength ening exercises on patellofemoral pain. Of the 30 pa tients with anatomically normal lower extremity align ment and no history of previous knee trauma or sur gery, there were 34 knees that had a decrease in peripatellar knee pain with a structured exercise pro gram. One additional patient had a decrease in pain after an arthroscopic lateral release and with continued exercises.
An equal number of skeletally immature patients and adults had a decrease in peripatellar knee pain. How ever, 5 of the 17 adults had to limit their activities, while no adolescent patient had to limit activity. Additionally, eight skeletally immature knees had greater than 5° change in their congruence angles, as measured on Merchant tangential radiographs, over the year-long course of this study. Only one adult knee had a similar radiographic improvement.
We recommend immediate action to alleviate patel lofemoral pain syndrome, even when extremity align ment is normal. An isometric, progressive resistance quadriceps program with iliotibial band and hamstring stretching exercises is the preferred initial treatment.
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