All About Chondromalacia

Chondromalacia is a condition in which abnormal softening or degeneration (or irritation) of the cartilage takes place. The cartilage which is affected is the articular cartilage. This is the most common cause of knee pain (anterior knee pain). This condition commonly affects the young, mainly women and is commonly referred to as ‘Runner’s Knee’.

In normal condition, the cartilage is smooth and elastic which glides over the thigh bone (femur bone) while bending. But in chondromalacia this cartilage shows blistering or other abnormalities on the surface.

This condition mainly arises due to any kind of injury, erosion or overuse of the joint by constant rubbing or by friction on a hard surface.

The articular cartilage in normal conditions acts as a ‘shock absorber’ .In chondromalacia, since the cartilage (articular cartilage) is affected it causes pain which is felt specially in the front part of the knee (anterior part). The pain may be of radiating type. Some believe chondromalacia might further progress to osteoarthritis if not detected or treated on time.

 

Causes:

1)    Due to any kind of injury, trauma to the joint area.

2)    In cases of overuse of the joint.

3)    Uneven pressure on the joint.

4)    Misaligned bones.

 

Symptoms:

1)    Pain around the knee cap.

2)    Tender knee.

3)    Pain which radiates to the back of the knee.

4)    Pain which increases on standing up or while climbing up and down the stairs.

5)    Increased pain on squatting.

6)    Grinding sensation of the knee specially on extending the knee.

7)    Swelling around the knee.

8)    Locking of the joint.

 

This condition mainly affects athletes, runners, soccer players, cyclists.

Treatment:

Most surgeons believe that chondromalacia should first be treated conservatively     (not surgically).However the treatment depends on the degree of severity of the condition. Whenever a conservative mode of treatment is decided one should remember the words: control, avoid and rehabilitate.

One should learn to control activities that cause pain. Avoid activities that cause stress over the joint area.

-Ice application (cryotherapy) over the affected area is a good way to get the pain under control. Special devices are available which are used to cool the joint.

-anti-inflammatory drugs and other pain controlling drugs can be used to bring about temporary relief.

-joint stability can be achieved by the help of a knee brace. A knee brace provides the needed support to the joint area.

One should try to avoid activities like walking up and down stairs unnecessarily, kneeling on the knees and keeping the knee bent for a long duration.

Efforts should be made to rehabilitate the knee. Proper exercise methods should be practiced.

Surgical treatment:

1)    Artheroscopy- which is a procedure in which first an incision is made through which a device is inserted which has a camera and a light attached to it and tiny fragments of bone are removed.

2)    Realignment of the joint can improve the condition of the patient.

Surgical treatment is necessary in severe cases of chondromalacia to correct the angle of the knee cap which may be causing friction in the joint area.

Low impact exercises like swimming are recommended provided the knee does not bend too much. Such exercises will help to strengthen the muscle (quadricepts) without injuring the joint.

Prognosis:

Prognosis in most cases of chondromalacia is good even with non surgical treatment methods. Most patients get relief from pain. If non surgical treatment methods fail then the surgical treatment may be necessary.


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