What is Chondromalacia and Why You Should Know About It
Chondromalacia sounds scary, but it’s a fairly common condition affecting active individuals. So if you’re an athlete or an active person, it’s important to know what chondromalacia patella symptoms are, as well as what chondromalacia patella treatment looks like. Keep reading to learn all you need to know about this condition including prevention, symptoms, and treatment.
What is Chondromalacia and How Does it Develop
Chondromalacia patella, sometimes referred to as “runner’s knee”, is a condition caused by the softening or degeneration of the articular cartilage located under and around the kneecap. It occurs when factors like age, increasing pressure on the knee, and weak quad muscles cause the kneecap to rub against the tip of your leg bone instead of gliding smoothly over it. This friction between your kneecap bone and the femur damages cartilage tissue, which, over time, can lead to more serious conditions such as osteoarthritis.
Chondromalacia can occur due to overuse of the knee joint from activities and movements requiring frequent use of the knees, like running or jumping, as well as acute injury. Other causes include an imbalance in muscle strength, anatomical abnormality of the patella (such as shallow knee joints or a wide pelvis), or improper biomechanics at the hip, ankle, and foot. When the injury happens over time, it usually goes through these four stages:
- Grade I: Softening of the cartilage
- Grade II: Tearing or fissuring of the cartilage surface
- Grade III: The tears and fissures become deep and involve more than 50% of the thickness of the cartilage
- Grade IV: The cartilage is worn down to bone
Chondromalacia Patella Symptoms
Chondromalacia often causes pain and irritation in the affected knee joint and surrounding area, but symptoms can vary widely between individuals. Chondromalacia patella symptoms may include swelling and tenderness around the kneecap, a grinding or cracking sensation when you move your knee joint, inability to fully straighten or bend your knee, or the knee catching, locking, or giving way. Individuals may experience only one or all of these symptoms, making chondromalacia difficult to self-diagnose. To ensure proper diagnosis of your knee pain, make sure to see an orthopedic specialist, like Dr. Goradia at G2 Orthopedics. Dr. Goradia carefully examines the joint, asks about pain and symptoms, and performs an X-ray to evaluate the knee. In some cases, he also orders an MRI to be taken.
How Chondromalacia Patella Impacts Athletic Performance
Chondromalacia can limit range of motion. This is particularly concerning for athletes who rely on their ability to move quickly and powerfully without putting too much strain on their bodies. This interference with the bodies’ movement mechanics can result in long-term muscular imbalances and further weaken tissue around the knee joint due to overcompensation from discomfort. Additionally, athletes with chondromalacia are more prone to injury because the weakened cartilage cannot absorb shock properly and too much force can cause other problems such as bone fracturing or ligament tears. So while it is important for anyone exhibiting chondromalacia patella symptoms to consult an orthopedic specialist, athletes have an added incentive to do so as addressing the condition can help prevent further injury and help them maintain peak athletic performance.
How to Prevent and Treat Chondromalacia Patella
To prevent chondromalacia, it’s important to actively stretch and strengthen the muscles around the knee, ensuring they remain strong enough to keep the kneecap in correct alignment. Additionally, regular, low-impact physical activity such as walking or swimming can reduce one’s risk of developing chondromalacia.
Chondromalacia patella treatments may include icing and resting the affected knee joint or wearing an adjustable patellar strap to reduce pressure on the knee. Strengthening exercises that target quads, hamstring, thigh and calf muscles will also help support joint function and reduce chondromalacia pain. Anti-inflammatory medications may help with pain from swelling, while physiotherapy exercises such as strengthening and stretching can help reduce muscle imbalances, which can lead to chondromalacia patella.
In severe cases of chondromalacia, surgery may be recommended in order to improve fit between kneecap and femur so that normal movement can occur again with less discomfort. Dr. Goradia at G2 Orthopedics uses a variety of orthopedic surgery techniques. He commonly uses the following techniques:
- Chondroplasty – This technique involves the removal of loose cartilage and the smoothing of the remaining, damaged cartilage. Patients generally recover quickly from this procedure and do not need crutches. Physical therapy, however, is advised in most cases following surgery.
- Microfracture – This procedure involves pricking the bone to increase blood flow back to the area, which transforms this part of the bone into cartilage.
- Osteochondral Grafting – Grafting requires replacing damaged cartilage with healthy cartilage, harvested either from the patient or a cadaver. It is generally used for small defects that penetrate down to the bone and not for larger areas of cartilage damage. Recovery requires 2 weeks on crutches and another 6 in a brace.
- Autologous Chondrocyte Implantation – This is the most advanced technique used in chondromalacia patella treatment and is generally applied toward younger individuals with acute injury. It involves the harvesting and reproduction of cartilage cells and later the injection of these new cells into the injury site beneath a piece of soft tissue.
Regardless of which treatment is chosen, chondromalacia needs to be addressed promptly due to its potential to lead to further joint damage. If the condition turns into osteoarthritis, chondroplasty may still be selected as a treatment option. However, often patients with arthritis will need ongoing medications or injections, and some may even need joint replacement.