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PFF General Statement of Agreement

Posted by on in Meetings

Patellofemoral General Agreement Statement from the PFF/ IPSG Consensus meeting sponsored by DJO International on March 6, 2008

  • Focal loading can be a cause of PF pain.
  • Overuse or at times cyclical overload of soft tissue or bone areas may explain the unusual and sometimes ill defined nature of anterior knee pain in some patients (Dye theory of envelope of load acceptance) Treatment should establish load reduction.
  • Patellofemoral imbalance (including but not limited to malalignment) may cause pain by virtue of cyclical soft tissue and/or bone overload.
  • Focal supraphysiological loading can, in some patients, be a cause of PF pain.
  • Structural damage of articular cartilage does not always result in anterior knee pain. However, there is growing evidence that a subset of patients with chondral lesions may have a component of their pain related to that lesion.

There are many alternatives for non-operative PF pain treatment that should be considered some of which may include medications that affect neural pain transmission.

History, exam, imaging and response to treatment (differential injection, specific unloading, medication and multidisciplinary evaluation) should correlate well and be consistent in order to localize pathology and to make a precise diagnosis. Treatment should be developed based on the most precise diagnosis possible. Persistence of pain may be related to inaccurate appraisal of the cause of pain and/or inappropriate treatment decisions, patient non-compliance or complications of surgical treatment.
A patient’s active participation and understanding in his/her treatment is necessary for optimal results.

PFF has established close working relationships with the International Society of Arthorscopy, Knee Surgery and Orthopedic Sports Medicine (ISAKOS), the International Patellofemoral Study Group (IPSG) and the Arthroscopy Association of North America (AANA).

b2ap3_thumbnail_PFF_Board_in_SF_2007.jpg

Pictured: Board Members Left-Right: Philippe Neyret, M.D., Eric Dahlinger, M.D,  Jack Bert, M.D. (incoming president of AANA) Peter Jokl M.D., Jack Farr, M.D., John Fulkerson, M.D, Eric Jania,  and Anthony Schepsis, M.D.

Patellofemoral Foundation Board of Directors meeting with Jack Bert, incoming president of the Arthroscopy Association of North America (AANA), in San Francisco on March 6, 2008.   The Board of Directors welcomed Jack Bert, incoming president of the Arthroscopy Association of North America(AANA), to the meeting and discussed a strategic alliance of the PFF with AANA to promote education of orthopedic surgeons about the patellofemoral joint. A proposal regarding this relationship was submitted to the AANA Board of Directors At its Board of Directors meeting April 2008, The Arthroscopy Association of North America (AANA) approved a formal relationship with the Patellofemoral Foundation (PFF) as a way of fostering and promoting patellofemoral research and education.

The shared goal is to foster and promote more and better education for AANA members regarding patellofemoral problems, as these can be complex and difficult to treat at times. PFF hopes to help AANA assume a leadership role worldwide in patellofemoral education, particularly as anterior knee pain (AKA patellofemoral pain) is very common among athletes and workers, as well as the elderly.

isakos ipsg aana

 

The Hartman Patellofemoral Reseach Fund was established in recognition of Mr. J. William Hartman. Mr Hartman, president of Hartman Newspapers, Rosenberg, Texas, expressed unhesitating and early support of the concept and mission of the Patellofemoral Foundation with his generous Founding Benefactor pledge.  Mr. Hartman renewed his committment to Patellofemoral Foundation in July 2007 with pledge of support for the next five years. We truly appreciate his dedication to Patellofemoral Foundation's mission. 

John J. Elias, M.D., Andrew J. Cosgarea, M.D. 
Medical Education and Research Institute of Colorado, Colorado Springs, CO
Orthapaedic Surgery, Johns Hopkins University, Baltimore, MD

John Elias and Andrew Cosgarea have reported new and exciting results from their PFF funded research. In a computer model of knees with dysplastic trochleas, they have established that proximal realignment (MPFL reconstruction) creates greater patellofemoral articular loads than tibial tubercle transfer. This important work helps to further clarify the need for distal alignment in controlling patellar instability when the trochlea is flat and there is lateral tracking of the patella. Click here for details.

Christiansen's PFF/ISAKOS award winning research found that there is no advantage to acute repair of the medial PF ligament after acute dislocation of the patella.
 

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