DefinitionArticular cartilage cushions the femur (thighbone) and tibia (shinbone) where they meet in the knee, allowing them to move freely and easily. Chondromalacia patella is a softening or wearing away of the articular cartilage on the undersurface of the patella (kneecap).
|Chondromalacia of the Knee|
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CausesChondromalacia patella is caused by repetitive motion and misalignment of the kneecap.This can occur due to:
- Birth defect in knee alignment
- Weak quadriceps
- Muscle strength imbalance between the inside and outside of the thigh
- Direct trauma
Risk FactorsChondromalacia patella is more common in adolescence and young adulthood. Other factors that increase your risk of chondromalacia patella include:
- Participation in activities like running, skiing, cycling, or soccer that put repeated pressure on the patellofemoral joint
- Knock-knee abnormality of the leg
SymptomsSymptoms may include
- Acute or chronic knee pain that worsens slowly over time
- A popping or cracking sound as the knee is flexed and extended
- Increased pain when climbing stairs, squatting, kneeling, or running
- Pain and stiffness in the knee after it is flexed for a long period of time
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. Your knee may need to be viewed. This can be done with:
TreatmentTalk with your doctor about the best treatment plan for you. Options include:
Acute CareRestYour knee will need time to heal. Avoid activities that place extra stress on your knee:
- Do not do activities that cause pain. This includes running, jumping, and weight lifting using the leg muscles.
- If normal walking hurts, shorten your stride.
- Do not play sports until your doctor has said it is safe to do so.
- Over-the-counter medication, such as ibuprofen or acetaminophen
- Topical pain medication—creams or patches that are applied to the skin to help with soft tissue pain
- Prescription pain relievers
SurgeryIn most cases, surgery is not needed. But for some patients who have continued pain, surgery may performed. Surgical procedures include the following:
- Moving the quadriceps muscle insertion on the lower leg to improve alignment
- Releasing the lateral thigh muscles and tightening the medial muscles
- Smoothing over the undersurface of the patella
- Implanting cartilage taken from one’s own knee
PreventionTo reduce your chances of chondromalacia patella, take these steps:
- Maintain a healthy weight to reduce stress on your knees.
- Properly warm up before exercising or doing any physical activity.
- Maintain proper strength by exercising the quadriceps, calf muscles, and hamstring muscles.
- Use proper footwear for your sport. You may need orthotic support to help correct misalignment.
- Slowly increase activity to avoid stress on the knee.
- Use proper form and technique for any sport.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
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Patellofemoral pain syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2013. Accessed February 28, 2014.
Patellofemoral pain syndrome (runner's knee). John Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/mens%5Fhealth/patellofemoral%5Fpain%5Fsyndrome%5Frunners%5Fknee%5F85,P07841/. Accessed February 28, 2014.
Runner's knee (patellofemoral pain). American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00382. Updated August 2007. Accessed February 28, 2014.
Pihlajamäki HK, Kuikka PI, Leppänen VV, Kiuru MJ, Mattila VM. Reliability ofclinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae. J Bone Joint Surg Am. 2010 Apr;92(4):927-934.
Vasiliadis HS, Wasiak J, Salanti G. Autologous chondrocyte implantation forthe treatment of cartilage lesions of the knee: a systematic review of randomized studies. Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1645-1655.
- Reviewer: Teresa Briedwell, PT, DPT
- Review Date: 02/2014
- Update Date: 02/28/2014