Chondromalacia Patella

Chondromalacia patellae, also known as “runner’s knee,” results from the softening of the cartilage beneath the kneecap. This condition is common among young athletes, although older individuals with knee arthritis are also at risk. Chondromalacia patellae is frequently considered an overuse sports injury, and temporary cessation of training may improve outcomes. However, if improper knee alignment is the underlying cause, rest alone may not be sufficient.

What are the common causes of chondromalacia patella?

When the components of the knee do not move efficiently, the kneecap may rub against the femur. This abnormal contact can gradually wear down the patella, leading to the development of chondromalacia patellae.

The improper movement of the kneecap may arise from the following:

• Poor kneecap alignment.
• Weakened quadriceps and hamstrings.
• Repetitive stress on the knee joint resulting from participation in sports that involve jumping or running.
• Trauma resulting from direct impact to the kneecap.

What are the common signs of chondromalacia patella?

The primary symptom of chondromalacia patellae is pain in the knee region, often referred to as patellofemoral pain. Patients may experience cracking or grinding sensations during knee extension or flexion. The pain often intensifies after prolonged sitting or during activities that place pressure on the knee.

The following diagnostic tests may be utilized to assist with diagnosis and to determine the severity of the injury:

• X-rays can reveal signs of misalignment, bone damage, or evidence of degenerative arthritis.
• Magnetic resonance imaging (MRI) scans are employed to assess the extent of cartilage degeneration.
• Arthroscopic examination is a minimally invasive diagnostic procedure that allows detailed visualization of the interior structures of the knee.

What are the treatment options for chondromalacia patella?

Treatment focuses on reducing pressure on the kneecap and knee joint. Initial management includes adequate rest, joint stabilization, and timely application of ice. Anti-inflammatory medications may be prescribed to reduce inflammation around the joint. If symptoms such as tenderness, pain, and swelling persist despite these interventions, physical therapy or, in some cases, surgical intervention may be considered.

When is surgery necessary for chondromalacia patella?

Surgery is generally only considered when symptoms persist despite conservative treatment or when there is significant cartilage damage, malalignment, or mechanical problems within the knee joint.

What surgical procedures are commonly used to treat chondromalacia patella?

The type of surgery performed depends on the severity of the condition and the underlying cause of the cartilage damage. Common surgical procedures may include:

• Knee arthroscopy – A minimally invasive procedure in which a small camera (arthroscope) is inserted into the knee joint to assess and treat damaged cartilage, remove loose fragments, or smooth rough cartilage surfaces.
• Chondroplasty – A procedure used to smooth and stabilise damaged cartilage beneath the kneecap.
• Lateral release surgery – Performed to release tight tissues on the outer side of the kneecap that may be contributing to poor patellar alignment.
• Patellar realignment procedures – Surgical techniques used to improve kneecap tracking and reduce abnormal pressure on the cartilage.
• Cartilage restoration procedures – In selected cases, advanced cartilage repair or restoration techniques may be considered when there is significant cartilage loss.