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Chondromalacia Patella

Definition


Disease: Chondromalacia Patella Chondromalacia Patella
Category: Bones, joints, muscles diseases
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Disease Definition:

The natural shock absorber, which is the cartilage under the kneecap (patella), is not guaranteed for lifetime. The general term that refers to damage to the cartilage under the kneecap is chondromalacia patella, which may be caused by injury, overuse or other factors. Patellofemoral pain is a more accurate term for chondromalacia patella.
To ease patellofemoral pain, the patient may sometimes need physical therapy or even surgery, even though simple treatments such as rest and ice usually help.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Here are the signs and symptoms of patellofemoral pain:
 

  • Pain in the knee when squatting or kneeling.
  • Knee stiffness
  • Increased pain when walking up or down stairs, which is the most common symptom
  • Knee pain after sitting for long periods of time
  • A dull, achy pain in the front of the knee
  • A grating or grinding sensation when extending the knee


The patient may treat his/her own knee pain when it is not severe or disabling, but a doctor should be consulted in case the pain doesn’t improve within a few days.

Immediate medical care should help the patient in the following cases:
 

  • Swollen knee
  • A painful knee that doesn't function properly after an injury
  • Having knee pain after a popping sound or snapping sensation
  • Chills, fever or redness around the joint, associated with the pain.
  • The knee locks rigidly in one position, or the kneecap is visibly out of place
  • A painful knee, even when not putting weight on it
  • The knee seems unusually loose or unstable when putting weight on it

Causes:

Patellofemoral pain is often caused by muscle weakness, injury or overuse in young adults and adolescents, and in some cases, an unusual alignment of the kneecap is responsible. Arthritis of the knee joint, which causes cartilage to lose its normal shock-absorbing ability, may be related to patellofemoral pain in the case of older adults. The pain may also be caused by flat feet or weak thigh and hip muscles. Patellofemoral pain may even be caused by something as simple as worn-out or ill-fitting shoes.
The risk of developing this condition is greater in runners and other people who routinely do a lot of exercise involving their lower legs. The condition is more likely to develop in women than in men.
Trauma to the kneecap, such as a dislocation or fracture, and malalignment of the lower extremity are other factors that may cause patellofemoral pain.

Complications

Complications:

Difficulty with routine activities, such as squatting and climbing stairs may result from patellofemoral pain.

Treatments:

These simple measures should be followed as a start to treating patellofemoral pain:
 

Avoiding any activities that increase pain, like climbing stairs

Taking pain relievers when needed, such as acetaminophen, or nonsteroidal anti-inflammatory pain relievers, such as ibuprofen or aspirin

Resting the knee as much as possible


Exercises and therapy:
Specific exercises or physical therapy to strengthen the muscles that support the knees and control limb alignment, such as the muscles around the hips (especially the hip abductors), the quadriceps and hamstrings, may be recommended to promote one's recovery. Knee braces or arch supports may be recommended in other cases.
To reduce pain and enhance the patient's ability to exercise, the physical therapist can show ways to tape the knee. The patient should choose activities that go easy on the knees when exercising, for instance even though the patient may be able to return to activities such as running, the number of miles he/she runs may need to be reduced until it doesn't hurt during or after exercise. After exercise, icing can be really helpful. However, the patient shouldn't rush back to activity because it may take six weeks or more before beginning to feel better.

TYPES OF SURGERY:
Surgery may be an option in rare cases, if the measures mentioned above aren't effective.

Arthroscopy:
Through a tiny incision, an arthroscope, which is a pencil-thin device equipped with a camera lens and light, is inserted into the knee during this procedure. To remove fragments of damaged cartilage, surgical instruments are passed through the arthroscope.

Realignment:
To realign the angle of the kneecap or relieve pressure on the cartilage, operating on the knee of the patient may be needed in more severe cases.

Prognosis:

Not Available

Expert's opinion

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Expert's opinion:

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