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Chondromalacia of the patella
Chondromalacia of the patella


Definition:

Chondromalacia patella is the softening and degeneration of the tissue (cartilage) underneath the kneecap (patella).



Alternative Names:

Patellofemoral syndrome



Causes, incidence, and risk factors:

Chondromalacia patella that occurs in adolescents and young adults is thought to be related to overuse, injury, or too much force on the knee. It is more common in females. Many young people have a slight problem with the position of the kneecap.

Chondromalacia patella may also be a sign of arthritis of the kneecap, which is usually seen in older individuals.

People who have previously had a dislocation , fracture , or other injury to the kneecap may be more likely to get chondromalacia.



Symptoms:
  • A grating or grinding sensation when the knee is extended
  • Knee pain in the front of the knee that worsens after sitting for a long period of time
  • Knee pain that worsens with using stairs or getting out of a chair
  • Knee tenderness


Signs and tests:

The doctor will perform a physical examination. The knee may be tender and mildly swollen, and the kneecap may not be perfectly lined up with the femur (thigh bone).

When you straighten your knee, a grinding sensation may be felt below the kneecap. Pressing the kneecap when the knee is straight may be painful.

X-rays are usually normal, although a special x-ray view of the kneecap may show signs of arthritis or tilting.



Treatment:

Temporarily resting the knee and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain. Physical therapy, especially quadriceps strengthening and hamstring stretching, may be helpful.

Limit participation in sports or strenuous activity until the pain has gone away. Avoid activities that increase the knee pain, such as deep knee bends, until the pain improves.

If the alignment of the patella cannot be corrected with therapy, surgery may be an option. Depending on the type of misalignment, the surgery may be arthroscopic (using a camera, which allows a smaller incision) or open.



Support Groups:



Expectations (prognosis):

Chondromalacia patella usually improves with therapy and use of NSAIDs. For the few people who need it, surgery is successful most of the time.



Complications:

The main complication is failure of treatment to relieve pain.

When surgery is necessary, surgical complications may include:

  • Failure to relieve pain
  • Infection
  • Worsening pain


Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of this disorder.



Prevention:

Avoid trauma or abnormal stress on the knee. Keep the leg muscles strong and flexible, especially the quadriceps and the hamstrings.



References:

May TJ. Persistent anterior knee pain. Am Fam Physician. 2007;76:277-278.




Review Date: 5/5/2008
Reviewed By: Andrew L. Chen, MD, MS, Orthopedic Surgery and Sports Medicine, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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