Chondromalacia

Chondromalacia can be defined as the degeneration of the cartilage in the knees. A chondromalacia patella is the softening of the cartilage underneath the patella or kneecap. Generally it is described as a pain beneath or the sides of the kneecap. Chondromalacia is often called Patellofemoral stress syndrome. When softening occurs, the cartilage breaks down causing irregularities along the under surface of the kneecap. Chondromalacia is caused by muscle imbalance like weak quadriceps and strong hamstrings. Excessive pronation as is the case when an arch collapses too much thereby causing the knee cap to twist sideways can also be a source for chondromalacia.

Chondromalacia occurs when the articular cartilage breaks down due to wear and tear process in the body. The patella cartilage is one of the earliest places in the body where cartilage breakdown can occur. This leads to degenerative arthritis or osteoarthritis in the knee joint. Chondromalacia also occurs frequently due to overuse and related trauma. Referred to as runner's knee, chondromalacia occurs in part time athletes and in professional sports person who trains more than usual. Due to overuse cartilage tear occurs and the knee starts giving way. Nagging injuries is also a common cause of chondromalacia in sports persons. Symptoms of Chondromalacia include pain in front of the knee around the kneecap as well as deep-seated pain in the back of the knee. There may be pain on squatting or kneeling. The knees might be tender and there may be swelling around the knee joints. In severe cases of chondromalacia a grating or grinding sensation of the bone are heard when the knee is extended.

After ascertaining the clinical history and a physical examination, the physician orders for x-ray of the knee. Even if the x rays are normal, a special x ray view of the patella view or 'sunrise' view shows the patella displacement or tilted laterally and the muscle (vastus lateralis) looks too tight or over powering.

In most cases of chondromalacia, exercises with or without formal physical therapy are enough to correct the problem. Physicians prescribe physical therapy if the pain persists. Icing an injured body part is an important part of the acute treatment process for Chondromalacia. A physician prescribes NSAID for chondromalacia to reduce pain and swelling. Sports medicine therapists often prescribe knee brace for patients who want to stay active in sports. This brace is known as a patella stabilizing brace. If the pain worsens, surgical treatment is suggested. Arthroscopy is a common orthopedic procedure for diagnosing and treating chondromalacia.

• Trauma and abnormal stress to the knee should be avoided.
  
• The leg muscles, especially the quadriceps and hamstrings should be maintained strong and flexible.
  
• Participation in sports and strenuous activities should be limited until the pain has gone away. Activities that increase the knee pain such as knee bends, should be avoided until the pain improves.
  
• Girls may develop this problem of Chondromalacia Patellae depending on the morphology. Tall and knock-kneed teenagers are more prone to develop chondromalacia especially if they have tightness of lateral muscles.