Chondromalacia patellae is a condition where the cartilage of the kneecap softens, leading to anterior knee pain. This condition is common in athletes and those with knee arthritis. The most common symptom is a dull, aching pain in the front of the knee, behind the kneecap. This pain can worsen when walking up or down stairs.
Chondromalacia patellae is a radiologic diagnosis characterized by pathologic wear and tear of smooth cartilage underneath the patella or kneecap. It is a common affliction among young, athletic individuals who can see the condition of the articular cartilage on the back of the kneecap from the inside rather than guessing at its condition from the outside. The most common symptom is a dull, aching pain in the front of the knee, behind the kneecap.
The exact etiology of chondromalacia is unknown, but risk factors include a history of anterior knee pain. Chondromalacia is a pathological diagnosis, but the term has a clinical meaning. Symptoms of chondromalacia include knee tenderness and pain that increases after sitting for a prolonged period, using stairs, or getting out of a chair.
Patella chondromalacia may also cause a grating feeling and pain at the junction of the thigh and kneecap. A lump may be visible at the site of the pain. Treatment for chondromalacia patellae involves addressing the underlying causes of the condition, such as the degeneration of cartilage and the deterioration of the patellar cartilage.
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What can be mistaken for chondromalacia?
Chondromalacia, a condition affecting the knee joint, can be diagnosed as patellofemoral pain syndrome or patellar tendinopathy, but it is not part of the PFPS umbrella. The pathophysiology of chondromalacia is distinct, and there is an alternative treatment. The knee consists of four major bones: the femur, tibia, fibula, and the patella. The patella articulates with the femur at the trochlear groove, and the articular cartilage on the underside allows the patella to glide over the femoral groove.
However, excessive turning forces on the lateral side can harm the articular cartilage, leading to degenerative changes. The quadriceps, which insert into the patella via the quadriceps tendon, are divided into four muscles: rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis.
What happens if chondromalacia is left untreated?
Chondromalacia patella is a severe knee disorder that can lead to severe pain and mobility issues if not treated properly. It occurs when the cartilage underneath the kneecap breaks down, causing swelling, stiffness, and tenderness in the joint. This condition can be caused by trauma, overuse of the knee, obesity, poor muscle control, flat feet, and tight muscles in the hips or legs. If left untreated, it can lead to chronic pain and even arthritis.
Treatment should be done with guidance from a healthcare professional, who will create an individualized treatment plan based on the individual’s specific needs. Common causes include injury or trauma, overuse of the knee joint, weakness around the hips or legs, obesity, flat feet, and muscle imbalances around the knee joint.
What is superficial chondromalacia?
Chondromalacia is a condition affecting the hyaline cartilage coating of bone articular surfaces, causing softening, tearing, fissuring, and erosion. It is often associated with the knee’s extensor mechanism and is often referred to as patellofemoral syndrome or runner’s knee. The condition can be caused by post-traumatic injuries, microtrauma wear and tear, and medication injections. It occurs in any joint, especially in joints with trauma and deformities like the knee and patella.
This activity discusses the etiology, presentation, evaluation, and management of chondromalacia patella, highlighting the role of the interprofessional team in evaluating, diagnosing, and managing the condition. Providers should perform various testing, including diagnostic imaging, to evaluate for chondromalacia patella.
Is chondromalacia bone on bone?
Chondromalacia is a condition where the cartilage inside a joint softens and breaks down, causing pain and rubbing between the bones. It can affect any joint, but is most common on the underside of the kneecap (patella). The condition starts as a small area of softened cartilage behind the kneecap, eventually cracking or shredding into fibers. In severe cases, the damaged cartilage can wear away completely, causing the exposed kneecap’s bony surface to grind against other bones.
Bits of cartilage can also float inside the joint, further irritating the joint’s cells, leading to joint effusion. Chondromalacia can be caused by various joint injuries and disorders, with knee chondromalacia often linked to injury, overuse, and poorly aligned muscles and bones.
Can chondromalacia patella be seen on xray?
The clinical evaluation of chondromalacia involves a patient’s history, symptoms, and physical examination. Key markers include pain during knee movements, muscle imbalances, and functional limitations. X-rays can reveal secondary changes like bone spurs, joint space narrowing, patellar malalignment, and subchondral sclerosis, indicating advanced chondromalacia. Management strategies include specific exercises, Platelet-Rich Plasma (PRP) injections, prolotherapy, and viscosupplementation.
Exercises can improve patellar tracking and joint stability, while PRP injections stimulate tissue healing and regeneration. Prolotherapy injections promote tissue repair and strengthen the patellar support system, while viscosupplementation lubricates the joint.
How bad is knee bone on bone pain?
Osteoarthritis is a degenerative joint disease that causes joint tissues to degrade over time, leading to an inflammatory reaction that pressures the knee bone. Initially mild, the pain can become intense during daily activities, affecting the quality of life. A healthy knee contains cartilage, a natural shock absorber, and synovium, the soft tissue that lines the joints. As the cartilage breaks down and wears away, the bones under the cartilage rub together.
Bone on bone knee pain occurs when the knees lack the synovial fluid needed for smooth joint glide. Osteoarthritis is divided into four stages: mild, moderate, and severe. In the mild stage, minor pain occurs after walking or running, with joint stiffness and tenderness. In the moderate stage, the knee cartilage narrows, causing discomfort during everyday activities. The most severe stage occurs when the knee cartilage is significantly reduced or dissipated, leaving the joint stiff and immobile.
In summary, osteoarthritis is a degenerative joint disease that can cause severe pain and limited mobility, affecting the quality of life. Treatment options include over-the-counter medications, joint injections, and lifestyle changes.
What is the pain on the outside of the knee?
Iliotibial band syndrome, also known as runner’s knee, is a condition characterized by irritation of the iliotibial band, a thick fibrous tissue, which results in pain in the knee joint. The pain is exacerbated by movement and alleviated by rest. The recommended treatment plan involves rest, ice, and the use of anti-inflammatory medications to alleviate pain, reduce swelling, and decrease tenderness. This condition is frequently exacerbated by prolonged periods of movement.
Is it OK to walk with chondromalacia?
The management of chondromalacia pain can be achieved through the engagement in low-impact activities, including walking on flat surfaces, yoga, swimming, kayaking, and rowing. It is advisable to refrain from activities that place undue stress on the knee joint, including running, jogging, climbing stairs or hills, knee bends, squatting, kneeling, and step aerobics. Adherence to a healthy lifestyle can assist in the management of chondromalacia patella and the prevention of further complications.
Is chondromalacia permanent?
Chondromalacia patella is a permanent condition involving an irreversible breakdown of the cartilage surface, which can progress over time. It is also known as arthritis, but it is often referred to as chondromalacia rather than arthritis. The condition can worsen over time, but avoiding overuse of activities like squatting or lunging can help slow down its progression. Physicians often refer to cartilage problems as chondromalacia rather than arthritis.
What is the difference between chondropathy and chondromalacia?
Chondromalacia is a condition characterized by the softening of cartilage, which can lead to painful surgery. It is characterized by patellar pain in the anterior side of the knee, worsening with prolonged sitting or descent. It is more common in young women and can be caused by degenerative, inflammatory post-traumatic mechanics. Chondromalacia is classified into four levels: Grade I, Grade II, Grade III, and Grade IV.
It occurs when kneecap movement is displaced, causing it to rub against the distal part of the femur. Other causes include kneecap malalignment, muscle weakness, and excessive activities that strain the kneecap, such as jumping and running.
Does chondromalacia hurt to touch?
Chondromalacia is a condition that is characterized by increased knee tenderness and pain. These symptoms are often heightened after prolonged periods of sitting, using stairs, or getting out of a chair. Additionally, patients may experience a grating or grinding sensation when the knee is straightened.
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Great explanation as usual! This seems to be a “knee topic” not discussed very often, so thanks for adressing it. I hope there’s enough interest in this topic to go further in depth on causes, such as prevalence among certain professions, injuries like repeated patellar subluxations, and Q angle variations–both genetic and between the sexes. And of course, the surgical approaches like chondroplasty, tendon releases, retinacluar imbrications, maquet procedure, etc.
Thanks for this article. I’ve read a lot of explanations about the different stages of chondromalacia patellar, but this is very clear about the mechanics. I’d love to know more about the long-term management of chondromalacia patellar. I can’t help feel like I’m on a long-term track to osteoarthritis and then a knee replacement. But I hope with proper management I can avoid that for decades. And I would be interested in reading your book about sport injuries if you make an English translation! Maybe just a digital release?
I developed cmp when I was 10 yrs old, dislocated the knee when working so had my 1st surgery at 19 and then again at 29yrs old. It’s been really bad for the past 3yrs so had an x-ray for the first time since diagnoses. I have been told on the last surgery that it’ll be a reconstruction if it plays up again and not even 40.