by EBSCO Medical Review Board

Definition

Chondromalacia patella is a wearing down of the cartilage around the kneecap.

Chondromalacia of the Knee
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Causes

This problem may happen due to overuse. It may also happen when a kneecap is not in line.

Risk Factors

This problem is more common in women. It is also more common in people under 40 years of age who are very active. The risk is greater in athletes, such as runners.

Other things that may raise the risk are:

  • Poor training techniques, such as adding mileage too quickly
  • A change in training surfaces
  • Focusing on a single sport rather than cross training
  • Having muscles that are not balanced

Symptoms

Problems may be:

  • Knee pain that is worse with use, such as when running or using stairs
  • Pain that has gotten worse over time
  • A cracking sound when moving the knee
  • Pain and stiffness in the knee after sitting for a long time

Diagnosis

The doctor will ask about your symptoms, health history, and the activities that you do. A physical exam will be done. It will focus on the knee. This is enough to make the diagnosis.

Treatment

The goal is to ease pain, improve motion, and stop or slow the problem from getting worse. This may be done with:

  • Home care, rest, and medicine to ease pain and swelling
  • Exercises to stretch and strengthen the muscles in the leg
  • Crutches to keep weight off the leg
  • A brace to keep the knee and foot from moving

Some people may need surgery, but it is not common.

Prevention

The risk of this problem may be lowered by:

  • Raising activity levels slowly
  • Varying activities rather than focusing on one
  • Using the right techniques when playing sports
  • Doing exercises that stretch and strengthen the leg muscles
  • Wearing proper sports shoes or corrective footwear

RESOURCES

American Orthopaedic Society for Sports Medicine  http://www.sportsmed.org 

OrthoInfo—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Orthopaedic Association  http://www.coa-aco.org 

Canadian Orthopaedic Foundation  http://www.canorth.org 

References

Knee pain. Merck Manual for Health Care Professionals website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/sports%5Finjury/knee%5Fpain.html. Updated January 2020. Accessed March 30, 2020.

Lester JD, Watson JN, et al. Physical examination of the patellofemoral joint. Clin Sports Med. 2014 Jul;33(3):403-412.

Patellofemoral pain syndrome. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/patellofemoral-pain-syndrome  . Updated November 6, 2019. Accessed March 30, 2020.

Patellofemoral pain syndrome (runner's knee). Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/mens%5Fhealth/patellofemoral%5Fpain%5Fsyndrome%5Frunners%5Fknee%5F85,P07841. Accessed March 30, 2020.

Runner's knee (patellofemoral pain). American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/patellofemoral-pain-syndrome/. Updated February 2015. Accessed March 30, 2020.

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