What is Chondromalacia Patella?

Chondromalacia patella refers to the degeneration of cartilage under the patella (knee cap) which results in pain in the front of the knee.  The degeneration causes the cartilage to soften and is the most common cause of chronic knee pain.

What causes Chondromalacia Patella?

Chondromalacia patella is typically caused by overuse of the knee joint, too much force being placed on the knee over time, or arthritis.  The condition can also be caused by a previous injury to the knee cap, such as a fracture or dislocation, or can occur in individuals that have a misaligned knee cap.  Muscle weakness of the quadriceps, hamstrings, or hip abductor muscles can add to the pain caused by this condition, as can problems with the feet, such as overpronation, flat feet, or wearing worn out shoes.

What are the symptoms of Chondromalacia Patella?

The primary symptom of chondromalacia patella is a dull aching pain that is felt in the front of the knee.  The pain may increase after sitting for long periods of time, when rising from a sitting position, or while walking up or down stairs, and is also aggravated by other activities.  Tenderness and stiffness may also be felt in the knee and in more severe cases, a grinding sensation may be felt when the knee is extended.

How is Chondromalacia Patella diagnosed?

A medical professional will take a complete medical history and will perform a physical exam.  Questions will also be asked related to the type and severity of symptoms, when they began, and what makes them better or worse.  The knee will be moved in various positions to check for pain, stiffness, immobility and evidence of a grinding sensation that occurs under the knee cap when the knee is straightened.  A check of the alignment of the knee cap will also be done.  X-rays may be performed to show signs of arthritis or previous injury and an MRI will show the soft tissue of the knee in greater detail, but these tests are not always necessary in diagnosing the condition.

When should I seek care for Chondromalacia Patella?

If you experience pain, tenderness, stiffness or swelling in your knee that does not improve following a period of rest and avoidance of activities that cause pain you should seek medical advice.  If your symptoms are caused by a traumatic injury, such as a fall or hard blow, or pain is accompanied by immobility or redness, warmth, or fever you should seek immediate medical attention.

What will the treatment for Chondromalacia Patella consist of?

Initial treatment of chondromalacia begins with resting and icing the knee and avoiding activities that place stress on the knee joint until the pain subsides.  Nonsteroidal anti-inflammatory medications can help reduce pain.  After a brief period of rest, physical therapy is often helpful and focuses on stretching and strengthening the muscles in the hamstrings, quadriceps, and hip abductor muscles in order to provide more support for the knee joint and to help align the knee cap correctly during activity.  Changes to activity levels or modifications in how certain activities are performed may be needed to prevent further degeneration of the cartilage.  A brace may be recommended to support the knee joint when resuming activities.  In some cases, surgery may be required to properly align the knee cap.

Which muscle groups/joints are commonly affected by Chondromalacia Patella?

Chondromalacia patella causes pain in the knee joint due to a degeneration of the cartilage behind the knee cap (patella).

What type of results should I expect from the treatment of Chondromalacia Patella?

Most individuals with chondromalacia patella will experience a reduction in pain in response to conservative treatments (rest, ice and NSAIDs) and a course of physical therapy.  Activities may need to be limited or modified, or a brace worn with activity, to prevent a recurrence of the symptoms.  When surgery is required to realign the knee cap, it is generally successful at alleviating symptoms.

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