Excessive lateral pressure syndrome

Last revised by Bálint Botz on 29 Mar 2022

Excessive lateral pressure syndrome or lateral patellar compression syndrome is the abnormal lateral tilt of the patella without lateral translation 1 and is considered one of the relatively common causes of anterior knee pain.

Excessive lateral pressure syndrome can affect both adolescents and adults. 

Patients usually present with insidious onset anterior knee pain aggravated by physical activity.

Excessive lateral pressure syndrome is due to an imbalance between medial and lateral dynamic stabilizers, either secondary to a shortened lateral retinaculum/vastus lateralis (more common) or a lax medial retinaculum/vastus medialis. This results in a lateral tilt of the patella without lateral translation, subluxation or dislocation. In some cases, even medial translation can be present 1

The main feature is abnormal patellar tilt without lateral translation/subluxation 1. Patellar tilt can be assessed with the patellofemoral angle 1. Joint effusions are uncommon 5.

Long-term excessive lateral pressure syndrome can result in chondropathy and patellofemoral osteoarthritis. Surgical treatments include arthroscopic lateral retinacular release 4,5.

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