Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Chondromalacia patella is abnormal softening of the cartilage of the underside the kneecap (patella). It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patella is one of the most common causes of chronic knee pain. Chondromalacia patella results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as patellofemoral syndrome.
What causes chondromalacia patella?
The patella (kneecap) is normally pulled over the end of the femur in a straight line by the quadriceps (thigh) muscle. Patients with chondromalacia patella frequently have abnormal patellar "tracking" toward the lateral (outer) side of the femur. This slightly off-kilter pathway allows the undersurface of the patella to grate along the femur, causing chronic inflammation and pain. Certain individuals are predisposed to develop chondromalacia patella: females, knock-kneed or flat-footed runners, or those with an unusually shaped patella undersurface.
Chondromalacia, or chondromalacia patellae, is a common cause of chronic knee pain. In chondromalacia, the cartilage beneath the knee cap softens and breaks down. Because the bone of the knee cap rubs against the thigh bone during movement, pain results as a symptom.