Knee Pain
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Dennis Lee, MD
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Your Knee Pain: Is It Chondromalacia?
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara
K. Hecht, PhD
Chondromalacia, technically termed chondromalacia
patellae, is the most common cause of chronic
knee pain. The condition is also called
the patellofemoral syndrome.
Softening of the cartilage beneath the knee cap (the patella) results in
small areas of breakdown and pain around the knee. Instead of gliding smoothly
over the knee, the knee cap rubs against the thigh bone (the femur) when the knee moves. The
changes can range from mild to complete erosion of the
cartilage.
Chondromalacia commonly occurs in females. Girls in their teens are at
elevated risk because the cartilage of the knee is subjected to excessive and
uneven pressure due to the structural changes that accompany rapid growth.
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How is the knee designed, and what is its function?
The knee is a
joint which has three parts. The thigh bone (femur) meets the large
shin bone (tibia) forming the main knee joint. This joint has an
inner (medial) and an outer (lateral) compartment.
The kneecap (patella)
joins the femur to form a third joint, called the patellofemoral joint.
The knee joint is surrounded by a joint capsule with ligaments strapping
the inside and outside of the joint (collateral ligaments) as well as
crossing within the joint (cruciate ligaments). These ligaments provide
stability and strength to the knee joint.
The meniscus is a thickened
cartilage pad between the two joints formed by the femur and tibia. The
meniscus acts as a smooth surface for the joint to move on. The knee joint
is surrounded by fluid-filled sacs called bursae, which serve as
gliding surfaces that reduce friction of the tendons. Below the kneecap, there
is a large tendon (patellar tendon) which
attaches to the front of the tibia bone. There are large blood vessels passing
through the area behind the knee (referred to as the popliteal space). The large
muscles of the thigh move the knee. In the front of the thigh, the quadriceps
muscles extend the knee joint. In the back of the thigh, the hamstring muscles flex the knee.
The knee also rotates slightly under guidance of specific muscles of the
thigh.
The knee functions to allow movement of the leg and is
critical to normal walking. The knee flexes normally to a maximum of 135 degrees
and extends to 0 degrees. The bursae, or fluid-filled sacs, serve as gliding
surfaces for the tendons to reduce the force of friction as these tendons move.
The knee is a weight-bearing joint. Each meniscus serves to evenly load the
surface during weight-bearing and also aids in disbursing joint
fluid for joint lubrication.
Next: What injuries can cause knee pain, and what other symptoms may accompany knee pain? »
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