2015 ISAKOS Biennial Congress Paper #140

The Association Between Patellofemoral Pain Syndrome and Hip Impingement

Werner van der Merwe, MBChB, FCS, Brandhof, Free State SOUTH AFRICA
Mediclinic Bloemfontein, University of the Free State, Bloemfontein, Free State, SOUTH AFRICA

FDA Status Not Applicable

Summary: In cases of patellofemoral pain syndrome recalcitrant to treatment, subclinical hip impingement was present and treated to allow successful rehabilitation and improvement of patellofemoral pain syndrome.




Patellofemoral pain syndrome ( PFPS) has been linked to abnormal alignment and function of the patellofemoral joint. Recent research has focused on factors increasing the propensity for anterior knee pain and in specific the effect of impaired hip abduction and external rotation strength. During the past decade the diagnosis and treatment of hip impingement has been the topic of numerous studies and is also associated with impaired hip muscle strength.

This study examines a possible relationship between hip impingement and patellofemoral pain syndrome.

Level 4 case series


Data was gathered retrospectively after hip arthroscopy on 24 patients who had primarily presented with ipsilateral patellofemoral pain syndrome.

After failed treatment of PFPS the diagnosis of subclinical hip impingement was made in this group of patients. Following failed conservative treatment this group underwent hip arthroscopy for treatment of hip impingement.


Following hip arthroscopy and rehabilitation patellofemoral pain improved in 23 of 24 patients. Improvement in KOOS score as well as improvement in Modified Harris Hip Score was seen in all patients and was statistically significant.


Subclinical hip impingement can be present and contribute to patellofemoral pain syndrome through dynamic malalignment of the patellofemoral joint. This should be ruled out in cases of patellofemoral pain syndrome recalcitrant to conventional treatment.