Prepatellar Friction Syndrome: a common cause of knee pain in the elite cyclist

Abstract

Background: Although anterior knee pain is extremely common in high-level road cyclists, the exact etiology still remains unclear.

Methods: A group of 28 professional male elite cyclists diagnosed with Prepatellar Friction Syndrome (PPFS) were retrospectively reviewed with specific attention for the typical history, clinical findings and treatment modalities.

Results: A traumatic onset of the complaints was reported by 10 athletes, while the complaints were caused by chronic overuse in the remaining 18 subjects. Conservative treatment delivered poor results and all cases were eventually treated surgically. Surgery confirmed macroscopic damage to at least one prepatellar fascial layer in all patients, after which partial fasciectomy was performed through a mini incision.

Conclusion: PPFS is a new clinical entity of the triple-layered prepatellar fascial structures. Correct diagnosis is critical and based on the typical history and clinical findings. Partial prepatellar fasciectomy is the treatment of choice in order to regain the pre-injury performance level.