Knee Pain (Chondromalacia Patella)
What is chondromalacia patella?
Chondromalacia patella (knee pain) is the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella). Pain results when the knee and the thigh bone (femur) rub together.
Who is at risk for chondromalacia patella?
People who are at risk for developing chondromalacia patella include:
- Those who are overweight
- People who have had an injury, fracture, or dislocation related to the kneecap
- Runners, soccer players, bicyclists, and other people who exercise often
- Teenagers and healthy young adults, more often females
Symptoms and Causes
What causes chondromalacia patella?
Chondromalacia patella often occurs when the undersurface of the kneecap comes in contact with the thigh bone causing swelling and pain. Abnormal knee cap positioning, tightness or weakness of the muscles associated with the knee, too much activity involving the knee, and flat feet may increase the likelihood of chondromalacia patella.
What are the symptoms of chondromalacia patella?
Dull, aching pain that is felt:
- Behind the kneecap
- Below the kneecap
- On the sides of the kneecap
A feeling of grinding when the knee is flexed may occur. This can happen:
- Doing knee bends
- Going down stairs
- Running down hill
- Standing up after sitting for awhile
Diagnosis and Tests
How is chondromalacia patella diagnosed?
A doctor will perform a physical examination of the knee to determine the cause of pain. If the diagnosis is not clear or symptoms do not improve a doctor may order one of the following:
- Blood tests and/or a standard knee X-ray - This may help to rule out some types of arthritis or inflammation.
- MRI scan- A tests that shows details of the knee joint and can reveal many cases of chondromalacia patella.
- Arthroscopy - A tiny, flexible camera is inserted into the knee to see exactly what the cartilage looks like.
Management and Treatment
How is chondromalacia patella treated?
The most common way to treat symptoms of chondromalacia patella is to rest the knee. Other ways to treat the symptoms include:
- Placing of an ice or cold pack to the area for 15-20 minutes, four times daily, for several days. Do not apply ice directly to the skin. Wrap the ice or cold pack with a towel.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief—These include ibuprofen, naproxen, and aspirin.
- Topical pain medication— These include creams or patches that are applied to the skin to help with soft tissue pain.
- Prescription pain relievers.
Other treatments or self-care include:
- Changing the way you exercise
- Doing exercises to both stretch and strengthen the quadriceps and hamstring muscles
- Losing weight (if you need to)
- Using special shoe inserts and support devices
- Taping to realign the kneecap
- Wearing the right kind of sport or running shoes
Outlook / Prognosis
What is the prognosis (outlook) for chondromalacia patella?
Individuals suffering from knee pain caused by chondromalacia patella often make a full recovery. Recovery can be as fast as a month or take years, depending on the case. Many long-term recoveries occur in teenagers because their bones are still growing. Symptoms tend to disappear once adulthood is reached.