• 1

    Bates B, Osterning L, Mason B, James L: Foot orthotic devices to modify selected aspects of the lower extremity mechanics. .Am J Sports Med 7::338. –342,1979.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Stougard J: Chondromalacia of the patellae. .Acta Orthop Scand 46::685. –694,1975.

  • 3

    Metcalf RW: An orthoscopic method for lateral release of the subluxating patella. .Clin Orthop 167::9. ,1982.

  • 4

    Goodfellow J, Hungerford DS, Woods C: Patellofemoral joint mechanics and pathology. 2: Chondromalacia patellae. .J Bone Joint Surg [Br] 58::291. ,1976.

    • Search Google Scholar
    • Export Citation
  • 5

    Outerbridge RE, Dunlop JAY: The problem of chondromalacia patellae. .Clin Orthop 110::117. ,1975.

  • 6

    Vuorinen OP, Tunturi T, Harkkonen M, et al: Chondromalacia patellae: Results of operative treatment. .Arch Orthop Traum Surg 104::175. –181,1985.

    • Search Google Scholar
    • Export Citation
  • 7

    Insall JN, Aglietti P, Tria AJ: Patellar pain and incongruence. 2: Clinical application. .Clin Orthop 176::225. –232,1983.

  • 8

    Hvid I, Anderson LI, Schmidt H: Chondromalacia patellae: The relationship to abnormal patellofemoral joint mechanics. .Acta Orthop Scand 52::661. –666,1981.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Clement DB, Taunton JE, Smart GW, McNicol KL: A survey of overuse running injuries. .Physician Sports Med 9::47. –58,1981.

  • 10

    Nawoczenski DA, Cook TM, Saltzman CL: The effect of foot orthotics on three-dimensional kinematics of the leg and rearfoot during running. .J Orthop Sports Phys Ther 21::317. –327,1995.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    McCulloch M, Brunt D, Vander Linden D: The effect of foot orthotics and gait velocity on lower limb kinematics and temporal events of stance. .J Sports Phys Ther 17::2. –10,1993.

    • Search Google Scholar
    • Export Citation
  • 12

    Tiberio D: The effect of excessive subtalar joint pronation on patellofemoral mechanics: A theoretical model. .J Orthop Sports Phys Ther 9::160. –165,1987.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    DeHaven KE, Dolan WA, Mayer PJ: Chondromalacia patellae in athletes. Clinical presentation and conservative management. .Am J Sports Med 7::5. ,1979.

  • 14

    Fischer RL: Conservative treatment of patellofemoral pain. .Orthop Clin North Am 17::269. –272,1986.

  • 15

    Norkin CC, Levangie PK: Joint structure and function: A comprehensive analysis, 2nd ed. FA Davis, Philadelphia, 1992.

  • 16

    Woodall W, Welsh J: A biomechanical basis for rehabilitation programs involving the patellofemoral joint. .J Orthop Sports Phys Ther 11::535. –541,1990.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Heartley FW, Allen PR, Patrick JH: Tibial tubercle advancement for anterior knee pain: A temporary or permanent solution. .Clin Orthop 208::215. ,1986.

    • Search Google Scholar
    • Export Citation
  • 18

    Tria AJ, Palumbo RC, Alicera JA: Conservative care for patellofemoral pain. .Orthop Clin North Am 23::545. –554,1992.

  • 19

    D’Amico JC, Rubin M: The influence of foot orthoses on quadriceps angle. .J Am Podiatr Med Assoc 76::337. –340,1986.

  • 20

    Eggold JF: Orthotics in the prevention of runners’ overuse injuries. .Physician Sports Med 9::125. –131,1981.

  • 21

    Root ML, Orien WP, Weed JH, Hughes RJ: Biomechanical examination of the foot Vol 1. Clinical Biomechanics, Los Angeles, CA, 1971.

  • 22

    Novick A, Kelley D: Position and movement changes of the foot with orthotic intervention during the loading response of gait. .J Orthop Sports Phys Ther 11::301. –312,1990.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Eng JJ, Pierrynowski MR: Evaluation of soft foot orthotics in the treatment of patellofemoral pain syndrome. .Phys Ther 73::67. –70,1993.

    • Search Google Scholar
    • Export Citation
  • 24

    McPoil TG, Cornwall MW: Footwear and foot orthotic effectiveness research: A new approach. .J Orthop Sports Phys Ther 21::337. –344,1995.

  • 25

    Fulkerson JP: The etiology of patellofemoral pain in young active patients: A prospective study. .Clin Orthop Relat Res 179::129. –133,1983.

    • Search Google Scholar
    • Export Citation
  • 26

    McCarroll JR, Odonohue DH, Crana WA: The surgical treatment of chondromalacia of the patellae. .Clin Orthop Relat Res 175::130. –134,1983.

    • Search Google Scholar
    • Export Citation
  • 27

    Bently G: Chondromalacia patellae. .J Bone Joint Surg [Am] 52::221. ,1970.

  • 28

    Jensen DB, Albrektsen SB: The natural history of chondromalacia patellae: A 12-year follow-up. .Acta Orthop Belg 56::503. –506,1990.

  • 29

    Kramer PJ: Patellar malalignment syndrome: Rationale to reduce excessive lateral pressure. .J Orthop Sports Phys Ther 8::301. –309,1986.

The Effect of Foot Orthoses on Patellofemoral Pain Syndrome

Amol Saxena Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA.

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Jack Haddad Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA.

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In a retrospective review of 102 patients treated for chondromalacia pa-tellae and patellofemoral pain syndrome/retropatellar dysplasia (PFPS/RPD), the effectiveness of semiflexible foot orthoses was investigated. The combined disorders were diagnosed in 89.3% of the patients. Subjects were 46 women and 54 men, aged 12 to 87 years (mean, 37.9 years; SD, 15.9), who exhibited excessive forefoot varus or rearfoot varus. The initial screening and clinical diagnosis were based on an examination by an orthopedist. Particular attention was directed to patellar crepitation, patellofemoral malalignment, Q-angle measurements, limitation of range of motion, and knee effusion. Patients were evaluated for the onset and duration of patellofemoral pain and degree of knee joint disease. Semiflexible orthoses for each subject were fabricated, based on a clinical lower extremity biomechanical examination. At their follow-up visit, 76.5% were improved and 2% were asymptomatic, showing a significant decrease in the level of pain with orthoses intervention (chi-square P < .001). Although multiple treatment modalities are used for these patients, the results suggest that the use of semiflexible orthoses is significant in reducing symptoms of PFPS/RPD. (J Am Podiatr Med Assoc 93(4): 264-271, 2003)

Corresponding author: Amol Saxena, DPM, Palo Alto Medical Foundation, 795 El Camino Real, Palo Alto, CA 94301.