Chondromalacia Patella

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Chondromalacia Patella is abnormal softening of the cartilage of the under the kneecap. It is the most common cause of chronic knee pain, resulting from degeneration of cartilage due to poor alignment of the kneecap as it slides over the lower end of the thigh bone. This process is, therefore, sometimes referred to as patellofemoral syndrome.

The main symptom is pain. The pain occurs beneath and on both sides of the kneecap. Other characteristics of the pain...

  • The pain can be acute or chronic.
  • A popping or cracking sound is often heard as the knee is flexed and extended.
  • Symptoms usually increase and worsen slowly, over a year or more.
  • Symptoms are usually most pronounced when...
  • .........Climbing stairs
    .........Doing any activity that puts pressure on the knee

  • Pain and stiffness in the knee often occur when the patient is sitting with the knee bent for a long period of time.

  • Causes:
    Chondromalacia patella occurs when...
  • The kneecap doesn’t move properly in the groove in the knee where it meets the femur.
  • There is a muscle imbalance of the thigh muscles, which control the patella.
  • This can occur due to...
  • Congenital conditions—A person is born with a misalignment of the kneecap.
  • Weak quadriceps—These muscles assist in proper movement of the knee joint. Weak quadriceps may allow the patella to move out of alignment.
  • Muscle imbalance—This usually occurs when muscles on the outside of the thigh are stronger than muscles on the inside.,/li>
  • Direct trauma—A fall or blow to the kneecap that damages the articular cartilage on the patella or the femur.
  • Repeated trauma—The result of running, jumping, skiing, or other activities that put repeated pressure on the kneecap.

  • Treatment:
    Treatments for chondromalacia patella include...

    The first line of treatment for chondromalacia patella is to...
  • Decrease physical activity to allow the mechanical irritation and inflammation to subside.
  • Ice the kneecap area for 15 minutes twice per day after physical activity and take anti-inflammatory medication to reduce inflammation and pain.
  • Wear an elastic or neoprene brace on the knee to help keep the kneecap in proper alignment.

  • . . . Exercise
    Once pain and inflammation have subsided, exercise to strengthen the quadriceps should begin. Exercise should be non-impact or low- weight bearing, such as...
  • Swimming
  • Riding a stationary bicycle
  • Using a cross-country ski machine
  • Isometric or closed chain quadriceps strengthening exercises

  • . . . Surgery
    In most cases, surgery is not needed. But for younger patients who have continued pain, surgery may help. Surgical procedures include the following:
  • Moving the quadriceps muscle insertion on the lower leg to improve alignment
  • Releasing the lateral thigh muscles and tightening the medial muscles
  • Smoothing over the undersurface of the kneecap

  • . . . Prevention
    To help prevent chondromalacia patella, do the following...
  • Do strengthening and stretching exercises for the...
    • Thigh muscles
      Calf muscles
  • Have footwear fitted with orthotic devices. These devices correct abnormal...
    • Mechanics of the feet
      Musculoskeletal alignment in the legs and knees

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