Fibrous tissue on the medial side of the patella. It is a passive medial stabilizer of the knee to control patellar tracking. May become injured with poor flexibility, overuse or trauma (Senavongse).
Pain and tenderness on structure (medial side of patella).
May be the source or a contributing factor of patella femoral pain syndrome (PFPS), repetitive or severe injury may lead to stretched/weakened or torn medial retinaculum (Dixit).
Rest and reduction in exercise or workload and possibly surgery.
Medial Retinaculitis-Rare condition seen almost exclusively in runners. Likely to be caused by a fatigue tear in the medial capsular insertion into the patella (Dutton). Diagnosis can be determined by a positive bone scan in medial edge of patella (Dutton).
Fibrous tissue on the lateral side of the patella that helps to control patellar tracking. If too tight may cause excessive lateral tracking which may lead to a lateral retinaculum release (Juhn). A tight lateral retinaculum can tilt the patella leading to increased pressure on the lateral facet causing pain (Ficat).
Pain and tenderness on structure (lateral side of patella) (Juhn).
Must rule out a tight iliotibial band (ITB) and weak quadriceps muscles (Juhn).
Taping the knee to promote medial glide and suggest a quality running shoe with arch support. If conservative treatment is unsuccessful recommend the lateral retinaculum release procedure, although this is thought to be an overused procedure (Juhn).
- Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed: The McGraw-Hill Companies, Inc.; 2008.
- Senavongse, W., Amis, A.A., The effects of articular, retinacular or muscular deficiencies on patellofemoral joint stability. JBJS, BR 2005. 87-B(4): p 577-582
- Dixit, Sameer M.D., Difiori, John M.D., Burton, Monique M.D., Mines, Brandon M.D. Management of Patellorfemoral Pain Syndrome. Am Fam Physician. 2007 Jan 15;75(2):194-202. http://www.aafp.org/afp/2007/0115/p194.html
- Ficat RP, Philippe J, Hungerford DS: Chondromalacia patellae: A system of classification. Clin Orthop 144: 55–62, 1979.
- Juhn, Mark S., D.O. Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment. Am Fam Physician. 1999 Nov 1;60(7):2012-2018. http://www.aafp.org/afp/1999/1101/p2012.html
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