Chondromalacia

Chondromalacia, also referred to as patellofemoral pain syndrome, occurs when the cartilage surface of the back of the patella (kneecap) is damaged. The underlying cause of the condition is not known, but it can be triggered by strenuous exercise or repeated knee injuries. In teenagers, chondromalacia may be caused by increased weight-bearing on the knee joint during a growth spurt. The condition may also be associated with a misaligned or a recurrently dislocated patella or with muscle weakness in the upper leg.


What are the symptoms?

Symptoms vary in severity from person to person but may include:

- Pin in the knee when the leg is bent and straightened (such as when going up or down stairs).
- Stiffness after prolonged sitting.
- Crepitus (a crackling noise) during knee movement.

Chondromalacia usually occurs in only one knee, although the condition does sometimes develop in both knees.

What might be done?

Your doctor will examine your knee and press down on the patella to see if your symptoms worsen. He or she arrange for X-rays of the knee and back of the patella. In severe cases, arthroscopy (below) may be performed to examine the interior of the knee joint and remove damaged cartilage.

Your doctor may advise you to take a painkiller or a nonsteroidal anti-inflammatory drug and to apply ice packs for pain relief. He or she may also advise exercise to strengthen thigh and knee muscles and reduce stress on the knee joint. You may be advised to wear a knee support as a temporary measure. In rare cases, surgery is necessary to realign the patella.

What is the prognosis?

Chondromalacia often improves over time and most people are not disabled, although they may have mild recurrences of pain in the knee. Regular exercise to strengthen the muscles of the thigh and the ligaments around the knee will reduce the risk of developing osteoarthritis in later life.