Chondro means cartilage and malacia means softening. It is the damage to the cartilage at the back of kneecap. This is a disease that is self limiting and usually affects adults from 15- 40 years of age.
Symptoms
- A knee with this problem hurts, swells and grinds, crepitus (popping and cracking) can be felt on moving the joint.
- The pain is localized in the front of the knee.
- Activities such as running, jumping stairs, hiking, squats and lunges will exacerbate the condition and increase the swelling.
On examination
- The knee may be swollen and have fluid in it.
- The knee may also pop and click when straightening the knee, or descending or ascending stairs.
- Getting up after prolonged sitting typically increases pain
INVESTIGATIONS
- Radiographs (x rays) may be normal or may show some tilt of the patella or narrowing of the joint surface.
- An MRI is also useful.
- But diagnosis is mainly clinical
Treatment of chondromalacia patella
- Decrease exposure to known aggravating activities including repetitive stair climbing, squatting, running, cycling (especially a stationary bicycle), weight lifting with free weights and even wearing high heels.
- Weight loss (if one pound is lost that decreases the pressure on the patella by 4 lbs
- Medications like Acetaminophen, Ibuprofen, Naproxen, NSAIDs
- Strengthening exercises that put less pressure on the kneecap are: leg presses and mini squats (0-60 degrees), hamstring curls and hip abductor exercises are useful. Avoid leg extension exercises.
- Surgery-arthroscopy to make the joint surface smooth. This is employed only in resistant cases
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