Chondromalacia


Overview

Chondromalacia Patella is a condition of the knee, where the articular cartilage situated behind the knee softens and wears out. Bones now rub against one another causing friction and pain. It is also referred to as runner’s knee. This deterioration of the cartilage happens due to overworking of the knee as in the case of sportspersons, and among older adults due to arthritis.  In certain cases, poor alignment of the kneecap is also a cause of knee pain.

Strenuous activity and sitting with bent knees for longer periods aggravates the pain. Resting alone may not help alleviate pain. Grinding sensation along with pain is severe when the knee and the thighbone (femur) rub together. Improving the alignment of the knee is important to manage pain.

What Causes Chondromalacia Patella?

Many conditions and circumstances lead to Chondromalacia Patella. Although it involves deterioration of the cartilage, repeated infections, and overuse of steroid injections, there can be other factors leading to this condition.

  • Abnormal rubbing of the kneecap- Improper movement of tendons and ligaments attached to the kneecap causes it to rub against the thighbone.
  • Congenital alignment problems.
  • Weak hamstrings and quadriceps due to lack of exercise.
  • Overworking of the knees especially in the case of sportspersons and runners.
  • Improper alignment of the kneecap because of a trauma.
  • Muscle imbalance between the outside and inside of the thighs known as adductors and abductors respectively.
  • Rheumatoid arthritis or osteoarthritis.
  • Repeated bleeding in the knee joints.

Symptoms

Discomfort and knee pain is the main indication of chondromalacia patella. If you notice any of the following symptoms, seek medical assistance.

  • Grinding or cracking sensation with knee movements.
  • Discomfort and pain in the knee that worsens by running or sitting for long hours.
  • Difficulty climbing the stairs.
  • Inability to stand for long hours.
  • The weakening of quadriceps resulting in pressure on the kneecap.
  • Inability to exercise due to discomfort in the knee.
  • Knee tightness.
  • Mild inflammation around the knee.
  • Constant nagging pain.
  • Difficulty standing from a sitting position.
  • Difficulty walking on slopes.

Who Are At Risk of Chondromalacia Patella?

  • Sportspersons are prone due to the strenuous use of their knees.
  • Adolescents and young adults going through growth spurts can face short-term muscle loss.
  • Obese individuals, for whom additional body weight puts a lot of pressure on the knee leading to wear and tear of the knee.
  • Women experience greater muscle loss as compared to men.
  • A sedentary lifestyle causes muscle loss.
  • Victims of knee injury are at high-risk of knee pain.
  • Arthritis causes inflammation in the knee joints causing acute pain
  • Flatfooted and knock-kneed people

Complications

  • Chondromalacia patella can impact the quality of life severely if not treated on time.
  • Since cartilage loss is permanent, timely action is crucial.
  • Surgery is the last resort even though it does not guarantee 100 percent recovery of the knee.

Diagnosis

Consult an Orthopaedic specialist for chondromalacia patella. The specialist usually performs the following steps before diagnosis.

  • Doctor clinically examines the hips, knee, thigh muscles, and ankles to evaluate the strength of the leg.
  • Observes the presence of any cracking or grinding sounds while moving the leg upwards and downwards.
  • Evaluates positioning of the knee, and checks for deformity, tenderness, and fluid in the joint.
  • X-ray of the knee to ascertain positioning of the kneecap.
  • MRI is performed to accurately assess the stage of the medical condition.

Grading of chondromalacia patella

Chondromalacia patella is categorized into four stages depending upon its severity.

  • Grade 1 indicates softening of the cartilage in the knee.
  • Grade 2 shows abnormal surface characteristics along with softening of the cartilage, marking the beginning of tissue erosion.
  • Grade 3 points to further thinning of the cartilage with the faster deterioration of tissue.
  • Grade 4 is obviously the most severe stage indicating the exposure of bone with very less cartilage presence. In this stage, bones rub against one another, which cause severe pain.

After grading of chondromalacia patella, specialists assess the progression of the condition and design treatment methods.

Treatment for Chondromalacia Patella

Anyone experiencing persistent knee pain must consult a medical specialist. Physical therapy and surgery are the two options available for treating chondromalacia patella. Doctors recommend surgery only when there is no relief with physical therapy. Therefore, the treatment always begins with non-surgical options.

 Physical Therapy

  • Initial treatment focuses on pain management for which some painkillers like Ibuprofen, naproxen are prescribed.
  • Patients must go slow with any kind of physical activity. Physiotherapy for 4 to 6 weeks with stretching and strengthening exercises reduces Chondromalacia patella.
  • Avoid squatting on the floor, climbing stairs and walking on inclined surfaces.
  • Strengthening the quadriceps, calf and hamstring muscles help in strengthening the knee for effective and permanent rehabilitation of chondromalacia patella.
  • Proper running shoes also keep knee pain at bay.
  • Quad sets are performed to a count of 10 and these sets of 10 contractions are ideally performed 15-20 times per day.
  • Avoid full squat exercises with heavy weights.
  • Cross-training exercises like swimming besides breaststroke can help to strengthen the thigh muscles.
  • Apply ice after exercise for pain and swelling.
  • For anatomic abnormalities such as flat feet, patients can look into orthotics for solutions.
  • Physical therapy also includes patellar taping and patellofemoral joint mobilizations.
  • Bracing is used where physical therapy does not yield good results. The patellar knee sleeve is the most commonly used braces along with patellar brace with rigid patellar restraints.
  • Kneecaps keep the knee joints centered and allow for free movement without causing friction to the joints or cartilage.
  • Injecting corticosteroid is a non-surgical option often used in treatment.
  • Viscosupplementation is used for pain management when the physiotherapy does not yield the required results.

Surgery

  • To examine the position of the knee joint, doctors perform Arthroscopic surgery. A camera is inserted into the joint after making a tiny incision to check the misalignment of the knee.
  • Few ligaments may be removed to allow more movement as it releases tension.
  • Smoothening the back of the kneecap, implanting a cartilage graft are some surgical options to treat chondromalacia patella.
  • In the case of patellar tracking abnormalities, a procedure called distal patellar realignment also helps.
  • Total knee replacement surgery(TKA) can help patients with chronic knee degenerative conditions. Victims of osteoarthritis also benefit from Such patients are able to regain use of their knee and enjoy the quality of life.

Home Remedies for Chondromalacia Patella

Few home remedies can help ease pain and discomfort associated with chondromalacia patella.

  • Cold compress: Apply cold packs to ease pain and help in healing.
  • Rest: Take a break from regular workouts and other activities to enable rest to the knee. Runners immensely benefit from resting as it reduces the pressure on the knee joints.
  • Massage: Use coconut oil, mustard oil, castor or garlic oil to massage gently on the knee. It gives relief from pain and swelling. This allows drainage of excess fluids and gives relief from arthritis.
  • Turmeric: Contains curcumin, which helps reduce inflammation and pain. Apply turmeric to improve blood flow in the knee.
  • Apple cider vinegar: Is good for runners as it reduces pain and swelling in the knee.
  • Cayenne pepper: Contains capsaicin, which contains natural pain relieving properties. Mix Cayenne pepper with coconut oil and apply on the knee twice or thrice a day. Wash with Lukewarm water to heal the pain quickly.
  • Elevation: Keep the knees in an elevated position above the chest level in a sleeping position, for better blood circulation. This also eliminates toxins from the affected area.
  • Ginger: Contains amazing healing properties. It is a natural painkiller and reduces inflammation.
  • Castor oil pack: Relieves discomfort associated with Chondromalacia Patella.
  • Compression: Compress the affected knee with a bandage to reduce fluid and inflammation.

Prognosis of Chondromalacia Patella

Prognosis of this condition depends upon the grade of classification during diagnosis.

  • Grade 1 has a good chance of recovery.
  • Grade 2 classification is not bad too as patients can recover well with proper care, medication, and physical therapy.
  • Grade 3 and 4 are more severe which requires surgery.
  • Complete recovery from chondromalacia patella is not possible because of poor healing of articular cartilage.
  • In the case of teenage girls, who undergo immense physical changes, the recovery rate is much better. Recovery time is long but one can expect a significant recovery in the case of younger people especially if the condition is diagnosed under grade 1.
  • Where physical therapy does not bring good results, surgery is the only option.
  • The success rate of surgery is 60 to 90 percent approximately. Patients’ commitment to treatment and strict adherence to guidelines enables a better prognosis of the condition.

Prevention of Chondromalacia Patella

Follow simple measures to prevent or at least delay the occurrence of chondromalacia patella.

  • Exercise the quadriceps, calf muscles, and hamstring muscles to strengthen and reduce weight on the knee joints.
  • Perform stretch exercises before and after any physical activity.
  • Wear kneecaps while exercising.
  • To correct any misalignment, wear appropriate footwear.
  • Excess weight exerts pressure on the knee joints. Weight management is the key to prevent knee problems.
  • Exercise under the guidance of a trained professional to prevent overworking of muscle groups as well as enable the right exercise for strength training and weight management.
  • To correct flat feet wear shoe inserts.

 

Facts

  • Statistics show that knee pain is a common condition in the present days with more than 100 million Americans suffering from it.
  • Treatment aims at the alignment of the kneecap as well as the strengthening of the knee.

Facts

  • Osteoarthritis of patellofemoral joint increases the risk of arthritis in older people.
  • Statistics from The American Academy of Orthopedic Surgeons, show that 90 percent of patients report relief from pain after knee replacement. They are able to continue with their daily activities and some even report being able to get back to fitness and exercise.

Facts

  • Close to 85% of artificial knees work well even after two surgeries.
  • Younger victims of osteoarthritis are now seeing greater benefits of Total Knee Replacement surgery to enjoy a better quality of life.

Related Conditions

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Dos and Don'ts

Dos
  • Seek the guidance of a professional trainer with strength training fitness programs.
  • Perform warm-up stretch exercises before and after physical activity.
  • Try wearing a kneecap.
  • Consume a balanced diet, high in nutrition and low on calories to keep weight in check.
  • Wear appropriate footwear for supporting the knee.
Don'ts
  • Sit or stand for long hours.
  • Overexert
  • Perform lunges and deep squats.
  • Be inactive for long periods.
  • Cycle or run with knee pain.
  • Increase the pace of running suddenly.

 

 

 

 

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Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
hepatitis B envelope antigen
Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
macadamia nuts in food
Proven health benefits and nutrition of macadamia nuts Know all about scientific, amazing health benefits of macadamia nuts, its nutrition, recipes, how to consume, price and…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…