Chondromalacia patellae
Encyclopedia
Chondromalacia patellae is a term that goes back eighty years. It originally meant "soft cartilage under the knee cap," a presumed cause of pain
at the front and especially inner side of the knee. This condition often affects young, otherwise healthy individuals.
Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.
The term "chondromalacia" sometimes is used to describe abnormal-appearing cartilage anywhere in the body. For example, a radiologist might note chondromalacia on an MRI of an ankle.
Pain at the front / inner side of the knee is common in young adults, especially soccer
players, gymnasts, cyclists
, rowers
, tennis
players, ballet
dancers, basketball players, horseback riders, volleyball players, and runners
. The pain of chondromalacia patellae is typically felt after prolonged sitting, like for a movie, and so is also called "movie sign" or "theater sign". Snowboarders and skateboarders are prone to this injury, particularly those specializing in jumps where the knees are under great stress. Skateboarders most commonly receive this injury in their non-dominant foot due to the constant kicking and twisting that is required of it during skateboarding.
The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee. Possible causes include a tight iliotibial band, neuromas, bursitis
, overuse, malalignment, core instability, and patellar maltracking.
Pain at the front of the knee due to overuse can be managed with a basic program consisting of RICE
(rest
, ice
, compression
, elevation
), anti-inflammatory medications
, and physiotherapy, however; if there is cartilage damage this is not easily repairable.
Usually chondromalacia develops with no swelling or bruising. The treatment of chondromalacia remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. Allowing the inflammation of chondromalacia to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee. The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the muscles of the hips and thighs. Use of nonsteroidal anti-inflammatory medication is also helpful to minimize the pain associated with chondromalacia. Treatment with surgery is declining in popularity for two reasons: good outcomes without surgery, and the small number of patients who actually benefit from surgical treatment.
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
at the front and especially inner side of the knee. This condition often affects young, otherwise healthy individuals.
Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.
The term "chondromalacia" sometimes is used to describe abnormal-appearing cartilage anywhere in the body. For example, a radiologist might note chondromalacia on an MRI of an ankle.
Pain at the front / inner side of the knee is common in young adults, especially soccer
Football (soccer)
Association football, more commonly known as football or soccer, is a sport played between two teams of eleven players with a spherical ball...
players, gymnasts, cyclists
Cycling
Cycling, also called bicycling or biking, is the use of bicycles for transport, recreation, or for sport. Persons engaged in cycling are cyclists or bicyclists...
, rowers
Sport rowing
Rowing is a sport in which athletes race against each other on rivers, on lakes or on the ocean, depending upon the type of race and the discipline. The boats are propelled by the reaction forces on the oar blades as they are pushed against the water...
, tennis
Tennis
Tennis is a sport usually played between two players or between two teams of two players each . Each player uses a racket that is strung to strike a hollow rubber ball covered with felt over a net into the opponent's court. Tennis is an Olympic sport and is played at all levels of society at all...
players, ballet
Ballet
Ballet is a type of performance dance, that originated in the Italian Renaissance courts of the 15th century, and which was further developed in France and Russia as a concert dance form. The early portions preceded the invention of the proscenium stage and were presented in large chambers with...
dancers, basketball players, horseback riders, volleyball players, and runners
Running
Running is a means of terrestrial locomotion allowing humans and other animals to move rapidly on foot. It is simply defined in athletics terms as a gait in which at regular points during the running cycle both feet are off the ground...
. The pain of chondromalacia patellae is typically felt after prolonged sitting, like for a movie, and so is also called "movie sign" or "theater sign". Snowboarders and skateboarders are prone to this injury, particularly those specializing in jumps where the knees are under great stress. Skateboarders most commonly receive this injury in their non-dominant foot due to the constant kicking and twisting that is required of it during skateboarding.
The condition may result from acute injury to the patella or from chronic friction between the patella and the groove in the femur through which it passes during motion of the knee. Possible causes include a tight iliotibial band, neuromas, bursitis
Bursitis
Bursitis is the inflammation of one or more bursae of synovial fluid in the body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless...
, overuse, malalignment, core instability, and patellar maltracking.
Pain at the front of the knee due to overuse can be managed with a basic program consisting of RICE
RICE (medicine)
RICE is a treatment method for soft tissue injury which is an acronym for Rest, Ice, Compression and Elevation. When used appropriately, recovery duration is usually shortened and discomfort minimized....
(rest
Rest
Rest may refer to:* Leisure* Human relaxation* SleepRest may also refer to:* Rest , a pause in a piece of music* Rest , the relation between two observers* Rest , a 2008 album by Gregor Samsa...
, ice
Ice
Ice is water frozen into the solid state. Usually ice is the phase known as ice Ih, which is the most abundant of the varying solid phases on the Earth's surface. It can appear transparent or opaque bluish-white color, depending on the presence of impurities or air inclusions...
, compression
Bandage
A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support to the body; they can also be used to restrict a part of the body. During heavy bleeding or following a poisonous bite it is important to slow the flow of blood,...
, elevation
Elevation
The elevation of a geographic location is its height above a fixed reference point, most commonly a reference geoid, a mathematical model of the Earth's sea level as an equipotential gravitational surface ....
), anti-inflammatory medications
Non-steroidal anti-inflammatory drug
Nonsteroidal anti-inflammatory drugs, usually abbreviated to NSAIDs or NAIDs, but also referred to as nonsteroidal anti-inflammatory agents/analgesics or nonsteroidal Anti-inflammatory medicines , are drugs with analgesic and antipyretic effects and which have, in higher doses, anti-inflammatory...
, and physiotherapy, however; if there is cartilage damage this is not easily repairable.
Usually chondromalacia develops with no swelling or bruising. The treatment of chondromalacia remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. Allowing the inflammation of chondromalacia to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee. The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the muscles of the hips and thighs. Use of nonsteroidal anti-inflammatory medication is also helpful to minimize the pain associated with chondromalacia. Treatment with surgery is declining in popularity for two reasons: good outcomes without surgery, and the small number of patients who actually benefit from surgical treatment.
See also
- KneeKneeThe knee joint joins the thigh with the leg and consists of two articulations: one between the fibula and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a mobile trocho-ginglymus , which permits flexion and extension as...
- Knee painKnee painKnee pain is a common complaint for many people. There are several factors that can cause knee pain. Awareness and knowledge of knee pain causes lead to faster diagnosis and treatment. Knee pain can be related to knee joint or around the knee.-Knee joint:...
- Patellofemoral pain syndrome
- Knee osteoarthritisKnee osteoarthritisKnee osteoarthritis is a degenerative disease of the knee joint. It is more common in people older than 40 years. Women have greater chance to be affected.-Signs and symptoms:Some of the signs and symptoms associated with knee osteoarthritis include:* Pain...
- Plica syndromePlica SyndromePlica Syndrome occurs when the plica becomes irritated or inflamed.-Presentation and pathophysiology:...
- Iliotibial band syndromeIliotibial band syndromeIliotibial band syndrome is a common injury to the thigh, generally associated with running, cycling, hiking or weight-lifting .- Definition :...