What Is Chondromalacia?
Chondromalacia, also known as runner’s knee, is a knee condition where the cartilage that sits behind the kneecap (patella) becomes soft. In a healthy knee, the patella slides smoothly up and down a channel on the femur called the femoral groove. Chondromalacia causes an abnormal movement of the patella so that it doesn’t move smoothly in the femoral grove.
Causes and Risk Factors
There are a number of possible causes of chondromalacia. They include:
- Abnormal positioning of the kneecap
- Flat feet
- Overuse of the knee
- Tightness or weakness of the muscles around the knee
The risk of developing chondromalacia is higher for people who:
- Are overweight or obese
- Are in their teenage years and female
- Exercise frequently, especially high-impact exercises like running or those that require knee flexion like biking
- Have had a knee injury in the past
Pain in the knee is the main symptom of chondromalacia. It can be brought on by activities that stress the knee, such as climbing up or down stairs, prolonged sitting and kneeling or squatting.
The first step in a chondromalacia diagnosis is usually a medical history. The doctor will ask about prior knee injuries and any activities that may be contributing to the pain. A physical exam usually involves looking for evidence of swelling, moving the knee to check for a grinding sensation and examining the kneecap’s alignment.
An X-ray will not detect cartilage abnormalities, but it can be helpful in ruling out other causes of knee pain. A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be able to show damage to the cartilage.
Chondromalacia is usually treated nonsurgically first. Conservative treatment measures may include:
- Avoidance of high-impact exercises
- Avoidance of squatting
- Exercises and physical therapy to strengthen the muscles around the knee
- Ice after activity
- Knee sleeves or braces
Nonsurgical treatment can often eliminate symptoms in a few months, but if symptoms are severe or do not resolve after treatment, surgery may be necessary. Surgery for chondromalacia is usually done arthroscopically—with small incisions, small tools and a flexible camera called an arthroscope attached to a video monitor. The surgeon will remove damaged cartilage and may also realign the kneecap.
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