Advanced chondromalacia patella answers on healthtap. The physical therapist will evaluate the patients mobility, flexibility and strength with the purpose of determining the underlying cause of the abnormal stress on the patella. Pain around the front of the knee is often referred to as patellofemoral pain. Chondromalacia patellae needs to be distinguished from osteoarthritis ofthepatellofemoraljoint. Patella alta can also be noted on the lateral view. Chondromalacia can be divided into 4 grades by mri, typically using fat saturated proton density sequences. Physical therapy is often recommended for treatment of pain and dysfunction associated with patellofemoral syndrome and chondromalacia of the patella. Chondromalacia patella, also called chondromalacia of the patella, condition in which the cartilage on the undersurface of the kneecap patella becomes softened or damaged. If problems continue, it would be best to work with a physical therapist and tailor an exercise program that improves your strength and aerobic capacity without worsening your symptoms.
The goal of treatment if to improve pain and improve function. Chondromalacia patellae is a distinct clinical entity characterized by retropatellar pain that is associated with recognizable changes in the articular cartilage of the posterior surface of the patella. Chondromalacia is a softening and subsequent roughening of the joints surfaces. The most common way to treat symptoms of chondromalacia. The qangle is a line created from the anterior superior iliac spine asis to the mid patella, which intersects with a line from the mid patella to the tibial tubercle when the knee is in full extension. Jtl wawi handbuch pdf use of nonsteroidal antiinflammatory medication is also helpful to minimize the swelling amplifying patellar pain. Obviously, a great starting point for treatment is to avoid these irritating activities as best you can. This decision is best made by your own orthopedist who has direct access to your x rays.
It is also important to wear shoes that fit well and that have good arch supports. Chondromalacia patellae, also known as runners knee, is a condition where the cartilage on the undersurface of the patella kneecap deteriorates and softens. You should also follow the steps of rice rest, ice, compress and elevate and wear a chondromalacia knee brace that helps with kneecap movement. Alignment or overuse problems of the patella can lead to wear and tear of the cartilage behind the patella. Pdf chondromalacia patella and new diagnostic criteria.
Dull, aching pain andor a feeling of grinding when the knee is flexed may occur. Patellar kneecap subluxation hawaii pacific health. Chondromalacia patella is a common knee problem that affects the patella and the groove it slides in over the femur thigh bone. Chondromalacia patella can be initially treated using simple measures such as providing rest to the knee and avoiding physical activities. The suc cess rate of most treatment regimes has been poor and in the long. Improper motion of the patella as the quadriceps muscle contracts. Pdf effects of plateletrich plasma in treatment of. How is a patellofemoral syndrome and chondromalacia. The patella is the kneecap which covers the knee joint.
Recovery period or healing time for chondromalacia patella varies with different patients and is dependent on the kind of surgery done. Theformeris usually a selflimiting condition of adolescence, with a predilection. Chondromalacia patellapatellar tendon injury treatment. Rehabilitation for patellofemoral syndrome chondromalacia patella brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. Cold compress putting an ice pack over the patella will help reduce the pain and swelling in the area. Chondromalacia patella is the most common cause of chronic knee pain chondromalacia patella has also been called patellofemoral syndrome. Treatment the best treatment for patellofemoral syndrome is to avoid activities that compress the patella against the femur with force. The patellofemoral joint is made up of the patella knee cap and the groove of cartilage on the femur in which it sits. Chondromalacia patella knee pain is the softening and breakdown of the tissue cartilage on the underside of the kneecap patella. In someone so young, if you can get away with something short of a total joint replacement, it is always preferable to do so. Chondromalacia patellae is a term sometimes treated synonymously with patellofemoral pain syndrome. When the knee moves, the kneecap patella slides to remain in contact with the lower end of the thigh bone trochlear groove of the femur. Acute treatment consists of cessation of the sporting activity.
I do not have any pain but i am not able to walk or take the stairs or use my knee i used to before. Nonoperative treatment chondromalacia patella rationale. The patella is a moveable bone in front of the knee wrapped inside a large tendon that connects the quadriceps. The vector force placed on the patella may be affected by the qangle. Lubrication viscosupplementation injections can help dismiss the symptoms and when combined with prp may help to create a smoother surface. The patella, or kneecap, can be a source of knee pain when it fails to function properly. Chondromalacia of the patella is the grating or grinding sensation during extension of the knee. Treatment of chondromalacia patella the treatment of this problem is usually nonoperative and includes. Treatment, surgery, recovery of chondromalacia patella. Chondromalacia patella is a condition in which the articular cartilage on the undersurface of the kneecap is softened and then deteriorated. Patellar kneecap subluxation rehabilitation exercise you may do all of these exercises right away. Chondromalacia is due to an irritation of the undersurface of the kneecap. This means avoiding going up and down stairs and hills, deep knee bends, kneeling, stepaerobics and high impact aerobics. While the term chondromalacia sometimes refers to abnormalappearing cartilage anywhere in the body, 9 it most commonly denotes irritation of the underside of the kneecap or patella.
Treatment with surgery is declining in popularity due to positive nonsurgical outcomes and the relative ineffectiveness of surgical intervention. It is one of several conditions that may be referred to as runners knee and is sometimes described as patellofemoral pain syndrome pain around. What can i do about chondromalacia patellae due to trauma. Resting, stabilizing, and icing the joint may be the first line of. Patellofemoral pain syndrome university health services. If it is symptomatic, pain management and rehabilitative treatment are the primary options. Chondromalacia patellae definition of chondromalacia. Poor mechanics with activities such as weight lifting. It is important to stretch the muscles in the back of your leg. A surgery can be performed if the nonsurgical treatments do not bring any relief.
Commonly used tests are blood tests, mri scans, and arthroscopy. It is also important to strengthen the muscles on the top of your thigh so your kneecap wont sublux again. Chondromalacia patella is due to overload of the patellofemoral joint knee cap against the end of the thigh bone. Muscle building activities under the guidance of a physiotherapist.
Chondromalacia patella is initially treated with physical therapy, strengthening exercises and surgical intervention if there is a mechanical issue. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. The number of patellofemoral problems is increasing. Rehabilitation for patellofemoral syndrome chondromalacia patella. But while these steps help with the symptoms of chondromalacia patella, they do not fix the. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. Treatment options for chondromalacia patellae the goal of treatment is to reduce the pressure on your kneecap and joint. Classically, the term refers to pathologic findings at the time of surgery. Chondromalacia patella was what put a hold on my running for a good while. Resting, stabilizing, and icing the joint may be the first line of treatment. This pain may be caused by soft cartilage under the kneecap patella, referred pain. The best treatment for patellofemoral syndrome is to avoid activities that compress the patella against the femur with force.
If these modalities are unsuccessful then surgery is an option. Platelet rich plasma prolotherapy for chondromalacia patella. Symptoms of chondromalacia patella include knee pain and a feeling of tightness or fullness. Pain results when the knee and the thigh bone femur rub together. Rehabilitation for patellofemoral syndrome chondromalacia. Chondromalacia patella treatment, exercises, surgery. Chondromalacia patellasports massageexercisesstretching. It happened because i used to kneel down a lot at work. Heres a question from a viewer regarding knee cap pain and some natural solutions that can help treat this injury. Chondromalacia patellae which is also known as cmp is inflammation of the underside of the patella and softening of the cartilage. Treatment r i c e rest, ice, compression and elevation are the common measures advised. Chondromalacia is usually associated with injury, overuse of the knee, and poorly aligned muscles and bones around the knee joint. Allowing inflammation to subside while avoiding irritating activities for several weeks is followed by a gradual resumption. Patellofemoral pain syndrome pfps is the most common cause of knee pain in the outpatient setting.
Chondromalacia patellae by definition means soft cartilage under the kneecap. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and. Athletes are advised to talk to a physician for further medical diagnosis as symptoms may be similar to more serious problems within the knee. Use of patella cut out braces to support the patella. Another useful method for the treatment of chondromalacia patella cmp is sports massage. Chondromalacia causes front knee pain, swelling and clickinggrinding noises when moving the knee. Chondromalacia patella is the most common source of chronic knee pain, causing pathological changes and possibly leading to deterioration of the articular surface of the patella.
The insallsalvati index is obtained by dividing the length of the patellar tendon by the length of the patella. The pain is caused by an irritation of the undersurface or patella of the kneecap as the kneecap rubs against one side of. Nonsteroidal antiinflammatory drug are used to neuralize the prostaglandins leading to articular cartilage breakdown. It tends to affect young, healthy and often sporty people, most commonly affecting adolescents and young adults. Patellofemoral pain syndrome is defined as pain around the kneecap. Description chondromalacia patellae cmp, also known as patellofemoral pain syndrome or patellofemoral stress syndrome. Patellofemoral pain syndrome can be a dif ficult condition to manage effectively. Archives of orthopaedic and traumatic surgery, 102, 95101 odonoghue dh 1981, treatment of chondral damage to the patella, amencan journal of sports medicine, 9 1, 110 outerbndge re 1964, further studies on the aetiology of. Chondromalacia patella is a common knee condition where there is softening and damage to the cartilage on the back of the patella kneecap.
Strengthening and stretching exercises are the 2 types of physical exercises which are recommended in order to recover as well as stop chondromalacia patella from recurrence. Patellofemoralchondromalacia protocol south shore orthopedics. A patients guide to chondromalacia patella compliments of. The cartilage damage resulting in runners knee can often repair itself with rest. Doctor answers on symptoms, diagnosis, treatment, and more. Current concepts of etiology and treatment of chondromalacia patellae. Chondromalacia is a condition in which the articular cartilage softens and wears out. Patellofemoral syndrome pfs is an irritation under the knee cap patella and the surrounding tissues due to increased compression.
Chondromalacia patella symptoms, treatment, surgery, and. Treatment treatment options for chondromalacia patellae the goal of treatment is to reduce the pressure on your kneecap and joint. Chondromalacia patella is a common knee problem that affects the patella. This cartilage normally glides effortlessly across the knee during bending of the joint.
Effects of plateletrich plasma in treatment of chondromalacia patella article pdf available in journal of mazandaran university of medical sciences 24114. It is estimated to occur in less than 20% of people who present with anterior knee pain. The pain of chondromalacia patella is aggravated by activity or prolonged sitting with bent knees abnormal tracking allows the kneecap patella to grate over the lower end of the thighbone femur, causing chronic inflammation and pain. The patella is covered with a layer of smooth cartilage, which normally glides across the knee when the joint is bent. This suggested exercise program is divided into three goaloriented phases. In the absence of cartilage damage, pain at the front of the knee due to overuse can be managed with a combination of rice rest, ice, compression, elevation, antiinflammatory medications, and physiotherapy usually chondromalacia develops without swelling or bruising and most individuals benefit from rest and adherence to an appropriate physical therapy program. Introduction the patella, or kneecap, can be a source of knee pain when it fails to function properly. Chondromalacia patellae definition chondromalacia patellae refers to the progressive erosion of the articular cartilage of the knee joint, that is the cartilage underlying the kneecap patella that articulates with the knee joint. Chattanooga, tn 423 6242696 when the knee moves, the kneecap patella slides to remain in contact with the lower end of the thigh bone trochlear groove of the femur. Treatment involves avoiding activities that irritate the cartilage under the kneecap, ice packs, antiinflammatory medications,physical therapy. As a result, the bones are not able to move freely and without pain. No single cure exists for the treatment of this problem. The condition may result from acute injury to the patella or chronic friction between the patella and a groove in the femur through which it passes during knee flexion. The cause is thought to be related to overuse, trauma andor abnormal forces on the knee, such as a mildly abnormal alignment of the patella knee cap and femur.
Pdf chondromalacia patella cmp is a disease in which the cartilage of patella is genetically soften and easily wears away. Patellofemoral syndrome tips and exercises my doctor online. There are a number of methods for measuring patella alta. There are a few other diagnoses that may be used for pain at or around the kneecap. Knee problems are very common, especially with hard training athletes.
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