Chondromalacia patella involves patella damage to the articular cartilage which is positioned beneath the kneecap. The condition is due to damage to the cartilage covering the rear part of the patella. This smooth, sturdy cartilage which is called hyaline or articular cartilage is responsible for smooth movement of the patella over the femur in the knee.
What are the possible causes?
Chondromalacia patella can be due to sudden impact or long-standing overuse. The acute injuries typically occur once the anterior part of the patella endures an impact such as a direct fall or struck from the front. As an outcome, small tears form or the cartilage becomes rough. As for overuse, the damage is due to constant rubbing of the cartilage on the bone.
In an individual with chondromalacia patella, the patella rubs against the region of the joint behind it, thus resulting to pain, inflammation and deterioration. There are various reasons for this, but usually due to the positioning of the patella.
The condition is common among young athletes. It typically affects females due to the increased Q angle. In addition, it is also common among those who had endured traumatic knee injuries previously such as dislocations and fractures.
The indications of chondromalacia patella strikingly resemble patellofemoral pain syndrome such as:
- Front knee pain and swelling particularly over and around the patella
- Pain or discomfort is aggravated when walking down stairs or sitting for extended periods of time
- Grinding or clicking sensation (crepitus) can be felt when flexing or straightening the knee
Aside from rest and application of ice and compression to reduce the swelling, there is little that can be done to cure the condition. It is vital to identify the cause and correct it if possible. When a doctor or sports medical professional is consulted, the treatment program includes the following:
Assessment of the knee
The knee joint is evaluated to confirm a diagnosis and rule out other injuries. The pain level, swelling and range of movement as well as wasting of the muscles or constricted structures that might be contributing factors should be determined. In addition, biomechanical factors are also assessed.
An X-ray is also used to rule out other injuries. An MRI is performed to confirm a diagnosis of the condition.
Pain and inflammation control
Rest along with the application of ice and compression can minimize the pain and swelling in the joint. Anti-inflammatory medications are also given by the doctor to reduce the inflammation, pain and swelling.
Taping of the patella is also recommended to correct the tracking of the kneecap which can reduce the pain by preventing it from rubbing continuously on the tender spot.
A rehabilitation program for the knee with specific exercises must be started. These exercises are aimed on improving the strength of the vastus medialis muscle on the interior of the joint as well as stretching of the lateral quadricep on the outside of the knee. In addition, sports massage can also help relax the lateral structures of the knee.
Even though uncommon, it is the last option if rehabilitation exercises are not effective. The surgery is carried out via an arthroscopy in which the damaged cartilage is taken out or shaved off.