- Signs & Symptoms
Chondromalacia patella facts
- Chondromalacia patella is the most common cause of chronic knee pain.
- Chondromalacia patella has also been called a patellofemoral syndrome.
- The pain of the 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 thighbone (femur), causing chronic inflammation and pain.
- Treatment involves improving the alignment of the patella during the contraction of the thigh muscle.
What is chondromalacia patella?
The chondromalacia patella is the abnormal softening of the cartilage of the underside of 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. It 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 a 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:
- Knock-kneed or flat-footed runners
- Those with an unusually shaped patella undersurface
What are the symptoms and signs of chondromalacia patella?
The symptoms of chondromalacia patella are generally a vague discomfort of the inner front of the knee, aggravated by activity (running, jumping, climbing, or descending stairs) or by prolonged sitting with knees in a moderately bent position (the so-called "theater sign" of pain upon arising from a desk or theater seat). Some patients may also have a vague sense of "tightness" or "fullness" in the knee area.
Occasionally, if chronic symptoms are ignored, the associated loss of quadriceps (thigh) muscle strength may cause the leg to "give out." Besides an obvious reduction in quadriceps muscle mass, mild swelling of the knee area may occur.
How is chondromalacia patella diagnosed?
Chondromalacia patella is suspected in a person with anterior knee pain, especially in teenage females or young adults. With manual compression of the kneecap, while the quadriceps muscle is tightened, there can be a pain. This is referred to as the positive "shrug" sign. Generally, there is no associated swelling (knee joint effusion).
X-rays or MRIs may be done to confirm the inflammation on the posterior part of the patella.
How do you fix chondromalacia of the patella?
The primary goal for the treatment and rehabilitation of the chondromalacia patella is to create a straighter pathway for the patella to follow during quadriceps contraction. Initial pain management involves avoiding motions that irritate the kneecap. Icing and anti-inflammatory medications (for example, ibuprofen [Advil/Motrin] or naproxen [Aleve]) can be helpful.
Selective strengthening of the inner portion of the quadriceps muscle helps 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 before 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 is required. Infrequently, surgical correction of knee alignment is considered.
Stretching and strengthening the quadriceps and hamstring muscle groups is critical for effective and lasting rehabilitation of the chondromalacia patella. "Quad sets" are the foundation of such a physical therapy program. Quad sets are done by contracting 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 to a fully functional level. Chondromalacia patella is not felt to be a precursor to degenerative arthritis (osteoarthritis).
Is it possible to prevent chondromalacia patella?
Chondromalacia patella can be prevented only in the sense that the symptoms can be prevented by avoiding any aggravating activities (running, jumping, etc.) or positions. Long-term prevention includes strengthening the inner portion of the quadriceps muscle to help normalize the tracking of the patella.
- FDA Panel Backs RSV Vaccine for Infants, Some Toddlers
- Seniors: Stay Social, Active for 'Optimal Aging,' Study Shows
- Diabetes Med Metformin Might Help Prevent Long COVID
- Disability a Growing Concern for U.S. Cancer Survivors
- Smoke From Wildfires Is Especially Tough If You Have Asthma. Here’s How to Protect Yourself
- More Health News »
Health Solutions From Our Sponsors
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
Ruddy, Shaun, et al., eds. Kelley's Textbook of Rheumatology. Philadelphia: W.B. Saunders Co., 2000.
Top Patellofemoral Syndrome Related Articles
How Do I Fix My Front of Knee Pain?Front of knee pain is also called anterior knee pain. Fix your front of the knee pain by using lifestyle changes, medical treatments, and exercises.
How Do I Know If My Knee Pain Is Serious?Some knee pain may subside with adequate rest and other physical therapies, which can be done at home; however, knee pain that doesn’t dissolve easily with rest should be considered serious and requires medical attention. Knee pain is the most common complaint of the musculoskeletal system.
Knee BursitisBursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms and signs include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Knee Injury and Meniscus TearsKnee injuries, especially meniscus tears, are common in contact sports. Symptoms and signs of a torn meniscus include knee pain, swelling, a popping sound, and difficulty bending the leg. Treatment may involve resting, icing, compressing, and elevating the knee, in addition to wearing a knee brace, taking anti-inflammatory medications, and stretching the knee.
Knee Joint PictureThe knee joint has three parts. See a picture of Knee Joint and learn more about the health topic.
Knee Pain: 8 Exercises to Help Your KneesGetting over a knee injury? WebMD shows you moves that can help make you stronger, so you're less likely to get re-injured.
Knee PainAcute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
MRI (Magnetic Resonance Imaging Scan)MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.
Pain ManagementPain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain include:
- complex regional pain syndrome,
- interstitial cystitis,
- and irritable bowel syndrome.
Knee Pain Dos and Don'tsYour knees go through a lot in the course of a day, and sometimes they can run into trouble. Here are a few things you can do when knee pain hits.
What Are the Symptoms of Nail-Patella Syndrome?Symptoms of nail-Patella syndrome include missing or underdeveloped nails, irregularly shaped kneecaps, abnormal bony growth in the pelvis, and dislocated joints.
What Helps Knee Pain from Sitting All Day?Knee pain can affect people at any age and can result from an injury or some type of medical condition. Things that help knee pain from sitting all day include the right mixture of stretching and strengthening exercises to help by improving joint movement and functioning.
What Is a Femoral Osteotomy?A femoral osteotomy is a surgical procedure that is performed to correct specific deformities of the femur (thigh bone). Orthopedic surgeons perform this operation to realign it and restore a more normal appearance. A femoral osteotomy is most often done in patients who are born with a hip abnormality under general or spinal anesthesia.
What Is the Reduction of a Patellar Dislocation?Patellar dislocations are common, particularly in adolescent females and athletes. Having a structural abnormality in the patella puts you at a high risk of patellar dislocations.
Will Patellar Tendonitis Ever Go Away?Patellar tendonitis will typically go away with rest, medications, and physical therapy. Although knee pain may resolve in 3-4 weeks, full recovery may take 6 weeks or longer. Check out the center below for more medical references on knee pain, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.