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Patellofemoral Syndrome (cont.)

How is chondromalacia patella treated?

The primary goal for treatment and rehabilitation of chondromalacia patella is to create a straighter pathway for the patella to follow during quadriceps contraction. Initial pain management involves avoiding motions which irritate the kneecap. Icing and anti-inflammatory medications (for examples, ibuprofen [Advil/Motrin] or naproxen [Aleve]) can also be helpful.

Selective strengthening of the inner portion of the quadriceps muscle will help normalize the tracking of the patella. Cardiovascular conditioning can be maintained by stationary bicycling (low resistance but high rpms), pool running, or swimming (flutter kick). Reviewing any changes in training prior to chondromalacia patella pain, as well as examining running shoes for proper biomechanical fit are critical to avoid repeating the painful cycle. Generally, full squat exercises with weights are avoided. Occasionally, bracing with patellar centering devices are required.

Stretching and strengthening the quadriceps and hamstring muscle groups is critical for an effective and lasting rehabilitation of chondromalacia patella. "Quad sets" are the foundation of such a program. Quad sets are done by contraction the thigh muscles while the legs are straight and holding the contraction for a count of 10. Sets of 10 contractions are done between 15-20 times per day.

What is the prognosis (outlook) with chondromalacia patella?

Under optimal circumstances, the patient should have a rapid recovery and return at full functional level.

Chondromalacia Patella At A Glance
  • Chondromalacia patella is the most common cause of chronic knee pain.
  • Chondromalacia patella has also been called patellofemoral syndrome.
  • The pain of chondromalacia patella is aggravated by activity or prolonged sitting with bent knees.
  • Abnormal "tracking" allows the kneecap (patella) to grate over the lower end of the thigh bone (femur) causing chronic inflammation and pain.
  • Treatment involves improving the alignment of the patella during contraction of the thigh muscle.

Reference:

Clinical Primer of Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.


Last Editorial Review: 1/28/2008


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