CHONDROMALACIA

KNEE TOPICS

*These pages are for informational purposes only and are not intended as medical advice. Please consult a physician for specific diagnosis and treatment options*

Chondromalacia is a condition that refers to the irritation and degeneration of articular cartilage found on the underside of the kneecap. Articular cartilage is a smooth, tough tissue that allows for the smooth movement when your knee bends and also functions as a protective barrier for the underlying bone.

There are a variety of reasons why chondromalacia may occur. A direct injury from sports activities or an injury, even general "wear and tear" of the cartilage over a period of time can cause irritation. When the kneecap is not aligned properly, it can prevent smooth movement when your knee bends. This causes the kneecap to rub against the thighbone and it begins to roughen the articular cartilage.

SYMPTOMS

A patient with chondromalacia may experience pain and swelling of their knee. Bending at the knees and climbing stairs tend to irritate the problem. A person may feel grinding in their knee when bending it.

DIAGNOSIS

Understanding your symptoms and examining your knee are the first steps in diagnosing the problems. Xrays can be helpful to determine if your patella is in proper alignment and any articular cartilage damage that has occurred.

TREATMENT

Non-surgical treatment would include resting the knee and taking anti-inflammatory medication to help reduce the inflammation and pain. An exercise regime may be set up to build up the strength in the muscles around your kneecap to help regain the proper alignment of the kneecap when the knee bends.

If non-surgical treatment does not help the problem, surgical intervention can usually be done arthroscopically. Smoothing over the surface of the patella with a shaver and suctioning out all of the loose fragments of articular cartilage (and possibly bone) are important aspects of the surgery.

If it is determined that the patella is out of alignment, a procedure known as a lateral release may be performed. With this operation, excessively tight tissue found on the outer part of the knee is cut which will return the patella to normal alignment. This surgery is typically done arthroscopically and no other incisions are required. This procedure is done on an outpatient basis and you will go home a few hours after surgery. In cases of severe malalignment, a portion of the patellar tendon (which is attached to the patella) may have to be shifted more toward the inside of the knee in order to bring the patella back into alignment. This operation is more involved and is done through an open incision. You can expect to stay in hospital for a day or two.