What is Chondromalacia patella- causes, symptoms, and 10 best exercises

What does the Chondromalacia patellae mean?

The cartilage on the patella's underside softens and degenerates when a person has a chondromalacia patellae (kneecap). Patellofemoral syndrome and anterior knee pain syndrome are other names for it. Typically, this condition makes the upper part of the knee painful and tender, especially when squatting, kneeling, or stair climbing.

Especially among young adults, sportspersons, and people who engage in repetitive knee movements, chondromalacia patella is a significant source of knee pain. Usually, arthroscopy, physical examination, and imaging tests like X-rays or MRI are used to make the diagnosis. Rest, physical therapy, anti-inflammatory drugs, and in some cases, surgery, may all be part of the treatment plan.

Relevant anatomy:

The knee joint, which joins the femur (thigh bone) to the tibia (shin bone), is a complicated hinge joint. It is the body's largest joint and is crucial for weight-bearing activities.

The knee joint is made up of three bones: the femur, tibia, and patella. The main joint space is created by the femoral condyle resting on the upper end of the tibia's flattened surface known as the tibial plateau.  The patella sits in front of the joint.  The knee joint is protected by the patella, which also increases the leverage of the knee quadriceps muscles.

When the cartilage on the patella's underside softens or degenerates, it develops a chondromalacia patella. The knee joint may become painful, swollen, and stiff as a result.

What causes the Chondromalacia patella?

Chondromalacia patella's exact cause is unknown, but a number of factors may play a role in its onset.

Overuse or Frequent Stress: Chondromalacia patella is frequently brought on by knee joint overuse or repetitive stress. Running, jumping, or cycling are examples of activities that frequently involve bending and straightening of the knee and may increase the risk of developing this condition.

Patellar Misalignment: The patella articulates with the femur and tibia and is embedded in the quadriceps tendon. The patella may not track smoothly as possible over the femur if it is not correctly aligned, resulting in friction and cartilage wear. A knee joint anatomical anomaly or muscle tightness, weakness, or imbalance may be to blame for this misalignment.

Injury or trauma: Injury to the knee joint can also contribute to the development of the chondromalacia patella. This may include a direct blow to the knee, a fall, or a twisting injury. Injuries can cause damage to the cartilage, leading to softening and degeneration over time. 

Genetic predisposition: Chondromalacia patella may have a genetic basis. Individuals may be predisposed to hereditary pathological changes in the knee joint.

Other aspects Obesity, ageing, and arthritis are some additional risk factors for the onset of chondromalacia patella. Obesity can increase the strain on the knee joint, damaging the cartilage over time. Chondromalacia patella risk may increase as we age due to natural cartilage breakdown in the knee joint. Chondromalacia patella can also be brought on by arthritis, a disease that damages and irritates the joints.

What are the symptoms of chondromalacia patella?

Pain at the front of the knee is the most typical sign of chondromalacia patella, especially when flexing the knee or stair climbing. The discomfort could be sharp or dull, and it might come and go.

When bending or straightening their knee, individuals with chondromalacia patella may also notice a grinding or clicking sound. The rubbing of the cartilage against the bone is what produces this noise.

Chondromalacia patella patients occasionally report knee joint swelling or inflammation.
Particularly after prolonged periods of inactivity or after prolonged periods of sitting, the knee may feel tight or stiff.

People may experience knee weakness or instability, which can make it challenging to run, jump, or walk.
While walking or standing, the knee may occasionally buckle or give way, which can indicate instability.
When pressed on the sides or directly beneath the patella, the kneecap may be painful to the touch.

Diagnosis of chondromalacia patella

Imaging procedures like X-rays, MRIs, or CT scans can be used to examine the knee joint's structure and determine the degree of cartilage damage. These examinations can also rule out other conditions, like a meniscus tear or a ligament injury, that could result in knee pain.

In order to evaluate your knee joint, your doctor will perform a physical examination, looking for things like kneecap stability, range of motion, tenderness, and swelling. To gauge the severity of your symptoms during the examination, they might ask you to move your knee in various directions or apply pressure to specific knee areas.

Sometimes arthroscopy can be suggested to rule out other conditions.

Treatment of Chondromalacia

Conservative treatment:

The most common method of treating chondromalacia patella is conservative measures. To lessen pain and swelling, use RICE (rest, ice, compression, and elevation).

It may also be advised to perform physiotherapy exercises to increase flexibility and quadriceps strength. Pain and inflammation can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.

Other conservative treatments might include modifying activities that aggravate symptoms and using bracing or taping to align the kneecap correctly and relieve pressure on the cartilage. Injections of corticosteroids may occasionally be used to treat knee joint inflammation. 

These conservative treatments can be combined to offer the best relief for the symptoms of chondromalacia patella and are typically successful in managing them.

Surgical treatment:

Surgery is typically only used to treat chondromalacia patella when all other treatments have failed or if the condition is extreme. The type of surgery performed depends on the location and severity of the cartilage damage. A small camera is inserted through a small incision into the knee joint during arthroscopic surgery in order to view and repair the cartilage. The roughened cartilage can be smoothed using this method, which can also encourage the growth of new cartilage.

To realign the patella and reorganize force on the knee joint, a surgical procedure known as a realignment may be required in more severe cases. The bones and ligaments surrounding the knee joint must be cut and realigned during this procedure to correct the misalignment.

Physical therapy is frequently advised after surgery to help the knee joint regain strength and range of motion. In general, surgery for chondromalacia patella can be successful.

10 best exercises for chondromalacia patella;

Straight leg raising
Wall slides
Quad sets
Hamstring curls
Stationary cycling


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