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Can Patellofemoral Pain Syndrome Cause Knee Arthritis

Can Patellofemoral Pain Syndrome Cause Knee Arthritis?

Can patellofemoral pain syndrome cause knee arthritis? This is a common question that many people ask when they are experiencing patellofemoral pain syndrome.

Patellofemoral pain syndrome is also known as patellofemoral joint (PFJ) dysfunction, which refers to the inflammation of the underside of your kneecap.

Does patellofemoral pain syndrome cause arthritis in your knee? The answer may surprise you! Many people who experience patellofemoral arthritis do not have any other symptoms besides knee discomfort.

Does Patellofemoral Pain Syndrome Cause Arthritis in the Knee?

Can Patellofemoral Pain Syndrome Cause Knee ArthritisNo, not initially, but it can if patellofemoral pain persists long-term and causes lasting changes in the integrity of the knee joint.

Patellofemoral pain syndrome does not directly cause patellar arthritis. However, long-term symptoms and chronic anterior knee pain may lead to weakness in the quad and poor tracking of the kneecap during movements. This long-term weakness and mal-tracking may eventually lead to arthritis many years down the road.

Patellofemoral Pain Syndrome is the irritation of the synovium and surrounding soft tissue around the knee cap. This typically affects people in adolescence and younger aged adults

It typically resolves with treatment within 6-8 weeks and some people never have symptoms again.

What is Chondromalacia Patellae?

Chondromalacia patellae is another condition that affects the patella, or knee cap. This occurs when there is softening of articular cartilage under your patella which can cause it to move in an irregular motion with each step you take.

This softening of the cartilage behind the knee cap causes increased wear and tear on the cartilage. This breaks down of the cartilage leads to patella arthritis. 

This type of arthritis may affect people who are middle-aged or older.

Chondromalacia vs Patellofemoral Pain Syndrome

There are many differences between patellofemoral pain syndrome and chondromalacia patellar however they are often used interchangeably.

  • Patellofemoral pain syndrome is caused by inflammation or irritation of the synovium, while chondromalacia patellae occur when there is softening of articular cartilage under your patella.
  • Patellofemoral pain syndrome is usually only felt on the knee cap and can be caused by many factors, while chondromalacia patellae is typically a degenerative condition of middle-aged or older people.
  • Patellofemoral pain syndrome affects younger adults and adolescents while chondromalacia typically affects older adults in their 40s-60s years of age.
  • Patellofemoral pain syndrome is usually treated with physical therapy, while chondromalacia patellae may require physical therapy, medication, or even surgery.

What Causes Patellofemoral Arthritis?

Patellofemoral arthritis is a condition caused by damage to the cartilage under your patella or kneecap. This is often associated with those who have been diagnosed with Patellofemoral pain syndrome, Chondromalacia patella, or other ligamentous injuries in the knee.

patella and knee xray

Risk Factors for Developing Patellar Arthritis

While patellofemoral arthritis can affect anyone, there are certain factors that may increase your chances of developing patellar arthritis.

  • those who have had knee injuries or surgeries in the past
  • Obesity
  • genetic predisposition to patella problems such as mal-alignment of the knee joint
  • Muscle weakness, especially quadriceps weakness and the glute muscles of the hip
  • Altered biomechanics in the knee most noted during walking

Does Having a Prior ACL Surgery Increase Your Risk for Patellar Arthritis

Yes, having a prior ACL reconstruction surgery has been shown to increase your risk of patellar arthritis.

This is thought to be linked due to the muscle imbalance in your quadriceps and glute muscles which may create an increase in patellofemoral pain syndrome symptoms over time leading to patella issues down the road.

This is the same risk for all of the different ACL graft options.

Does Patellarfemoral Arthritis Hurt?

Patellofemoral osteoarthritis may lead to knee pain in the advanced stages however the relationship between joint structure and pain is not fully appreciated.

There seems to be a higher relationship with increased pain with lateral patellar arthritis as compared to when the medial or the inside of the kneecap wears down the cartilage.

What is known is that the infrapatellar fat pad which lies underneath the kneecap is quite painful when it gets irritation. This fat pad has a lot of nerves that run to it so small changes in the area near the fat pad can cause significant pain.

Patellar arthritis may not cause pain with the loss of cartilage as much as it begins to continually irritate the infrapatellar fat pad.

Tips for Preventing Patellar Arthritis

There are several tips for individuals who have patellofemoral pain to help prevent patellar knee arthritis from developing long term.

Improve Strength for Preventing Arthritis

Strengthening the patellofemoral joint and surrounding muscles including the glutes, quadriceps, and hip muscles can help increase patellar stability.

This is thought to reduce pain as well as potentially slow down any patella degeneration that may occur over time.

Using pain as your guide as you try to strengthen the legs without irritating the kneecap.

Try a Patellofemoral Tracking Knee Brace

Patella tracking brace for patella arthritisA patellofemoral knee tracking brace may provide patella stability and help reduce the symptoms of Patellofemoral arthritis.

It can also allow you to do the activities that you use to love doing but without or with less pain.

Get a Running Analysis to Prevent Excessive Loads on the Kneecap

A patellofemoral running analysis can help determine the best running technique for you to reduce excessive forces on the patella.

This is especially helpful in runners who have patellar arthritis or are at risk of developing patellofemoral arthritis because they put too much strain on their knee when running resulting in pain, swelling, and patella instability.


Patellar arthritis is a patella condition that can be very painful with a significant impact on quality of life.

Those who have patellofemoral pain syndrome or chondromalacia patellae in the past are at higher risk for developing patellar arthritis over time and would benefit from improving strength, stability, and biomechanics in order to reduce patellar inflammation and knee pain.

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Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.