Chondromalacia Patella: Causes, Symptoms and Treatment

Your knee is the largest joint in your body and it joins your leg with the thigh. Each knee has 2 joints, one between the femur and patella (patellofemoral joint) and one between the femur and tibia (tibiofemoral joint). 

Chondromalacia patellae (or “runner’s knee”) is caused by the softening of your kneecap cartilage. Common among young athletes, it might also affect older adults with knee arthritis.

Chondromalacia is mostly seen as an overuse injury in sports, and sometimes taking some days off from training can produce good results. In other cases, the cause is improper knee alignment, and simply resting does not provide relief.   A conversation with your healthcare provider will help you get clarity for further courses of tests or treatments.

What is Chondromalacia Patellae?

The deterioration or softening of the cartilage on the bottom of the kneecap is known as chondromalacia patellae. It is comparable to patellofemoral pain syndrome (runner’s knee), in which the kneecap and surrounding area are painful.

This condition is common among young athletes but may also occur in older adults who have arthritis of the knee. 

What are the Symptoms of Chondromalacia Patellae?

A smooth (articular) cartilage layer covers the top of the thigh bone and the bottom of the kneecap, allowing the two bones to easily glide over one another. When the knee is bent or stretched, the injured cartilage can cause the joint’s surface to become rough and easily inflamed. The pain might range from mild to severe depending on the severity of the injury.

A dull discomfort under or around the kneecap that worsens when going downstairs is the most typical sign of chondromalacia patellae. Additionally, there could be pain while getting out of a chair or ascending steps.

When moving the knee, a person with chondromalacia frequently complains of a grinding or cracking sensation. When doing activities that put a lot of strain on the knees, such as exercising, or after sitting or standing still for a long time, the discomfort is frequently severe. Additionally typical are kneecap swelling and irritation.

What are the Causes of Chondromalacia Patellae?

Normally, your kneecap sits on top of your knee joint. The back of your kneecap slides across the femur, or thigh bone, at the knee as you bend your knee. Your kneecap is joined to your shinbone and thigh muscle via ligaments and tendons. Your kneecap may bump against your thigh bone if one of these parts isn’t functioning properly. This unnatural rubbing can cause the patella to deteriorate, which causes chondromalacia patellae, often known as runner’s knee.

Improper kneecap movement may result from:

• a direct strike to the kneecap or other injury
• putting strain on your knees repeatedly while jogging, skiing, or jumping
• adductors and abductors, the muscles on the outside and inside of your thighs, have an imbalance.
• weak quadriceps and hamstrings, which are the muscles at the front and rear of your thighs, respectively
• poor alignment due to a congenital condition

What are the Risk Factors for Chondromalacia Patellae?

Several things might make you more likely to get chondromalacia patellae.

• Arthritis

Inflammation of the joint and surrounding tissue is a sign of arthritis, which can also cause a runner’s knee. The kneecap may become dysfunctional due to inflammation.

• High Activity Level

A high level of activity or regular exercise that stresses your knee joints might raise your chance of developing knee issues.

• Previous Injury

Your chance of getting a runner’s knee might rise if you have previously suffered from a kneecap injury, such as a dislocation.

• Flat Feet

The knee joints may experience more stress from flat feet than from higher arches.

• Sex

Since women normally have less muscle mass than men do, they are more susceptible to acquiring a runner’s knee. This may result in improper knee alignment and increased lateral (side) kneecap pressure.

• Age

Young adults and adolescents are particularly vulnerable to this illness. Rapid bone and muscle development during growth spurts may cause temporary muscular imbalances.

What is the Treatment for Chondromalacia Patellae?

Your kneecap and joint are under pressure, thus the treatment aims to lessen it. The first course of therapy could involve resting, stabilising, and applying ice to the joint. Resting frequently helps to heal the cartilage damage that results in a runner’s knee.

To minimise inflammation around the joint, your doctor may recommend anti-inflammatory medicine for many weeks. The following treatments should be considered if swelling, soreness, and discomfort continue.

• Physical therapy

Quadriceps, hamstrings, adductors, and abductors-specific physical treatment can help you gain more muscular strength and balance. The balance of muscles will aid in preventing knee misalignment.

Non-weight-bearing workouts like swimming or using a stationary bike are frequently advised. Furthermore, isometric workouts that require you to contract and release your muscles can support the maintenance of muscular mass.

• Surgery

To inspect the joint and establish whether the knee is misaligned, arthroscopic surgery may be required. This procedure entails making a small incision to put a camera into your joint. A surgical surgery might resolve the issue. A lateral release is one typical method. To relieve stress and promote a greater range of motion, this procedure entails cutting a few of your ligaments.

Other surgical procedures can include repositioning the insertion of the thigh muscle, implanting a cartilage graft, or smoothing the rear of the kneecap.

How can you Prevent Chondromalacia Patellae?

By heeding the advice below, you can lessen your chance of acquiring runner’s knee:

• Put on shoe inserts that raise your arch to treat flat feet. Your knees will experience less strain as a result, and the kneecap could realign.
• Create muscle balance by strengthening your quadriceps, hamstrings, abductors, and adductors.
• Don’t subject your kneecaps to repetitive stress. If you must spend time on your knees, put on knee protection.

Finally, carrying extra weight may put a strain on your knees. It might assist in relieving pressure on the knees and other joints by maintaining a healthy body weight. By consuming less sugar and fat, eating more fruits, vegetables, and whole grains, and engaging in at least 30 minutes of exercise five days a week, you may take measures to reduce weight.

Conclusion

The weakening of the cartilage in your kneecap is what causes chondromalacia patellae, also known as “runner’s knee”. Sometimes, resting is insufficient for recovery and in bringing comfort, so it is always advisable to seek medical help from an experienced orthopaedist. Timely care and help can ensure an appropriate diagnosis and treatment of your condition. 

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to Consult an Orthopaedist, reach out to us, or book a direct appointment with Dr. Debashish Chanda at the CK Birla Hospital.

FAQs

Is Walking Bad for Chondromalacia Patellae?

You can remain active while you have chondromalacia patellae, as long as you stick to activities that don’t put any stress on your knee. Low-impact activities are best, such as walking on flat surfaces.

Do I Need Surgery for Chondromalacia Patellae?

The problem can sometimes get better with rest and anti-inflammatory medications. In many situations, the issue becomes worse with activity and gets better with rest since the kneecap has been out of alignment for the whole person’s life. A lot of individuals decide to get surgery to fix this issue.