Chondromalacia Patellae (“Runner’s Knee”)

Chondromalacia patellae is abnormal softening of the cartilage of the underside the kneecap (patella). It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patellae is one of the most common causes of chronic knee pain.

 Chondromalacia patellae results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as patellofemoral syndrome.

Chondromalacia is often seen as an overuse injury in sports, and sometimes taking a few days off from training can produce good results. In other cases, improper knee alignment is the cause and simply resting doesn’t provide relief. The symptoms of runner’s knee are knee pain and grinding sensations, but many people who have it never seek medical treatment.

 Causes of Chondromalacia Patellae

Your kneecap normally resides over the front of your knee joint. When you bend your knee, the backside of your kneecap glides over the cartilage of your femur, or thigh bone, at the knee.

Tendons and ligaments attach your kneecap to your shinbone and thigh muscle. When any of these components fails to move properly, it can cause your kneecap to rub up against your thigh bone. This abnormal rubbing can lead to deterioration in the patella, resulting in chondromalacia patellae, or runner’s knee.

Improper kneecap movement may result from:

· poor alignment due to a congenital condition;

· weak hamstrings and quadriceps (the muscles in the back and front of your thighs, respectively);

· muscle imbalance between the adductors and abductors (the muscles on the outside and inside of your thighs);

· repeated stress to your knee joints, such as from running, skiing, or jumping; or

· a direct blow or trauma to your kneecap.

Symptoms of Chondromalacia Patellae

Chondromalacia patellae will typically present as pain in the knee region, known as patellofemoral pain. You may feel grinding or cracking when bending or extending your knee. The most common symptom is knee pain that worsens when walking up or down stairs. Kneeling, squatting or sitting cross-legged may also hurt.

Talk to your Podiatrist if you have knee pain that doesn’t improve within a few days.

Who is at risk for Chondromalacia Patellae?

There are a variety of factors that may increase your risk for developing chondromalacia patellae.

Age: Adolescents and young adults are at high risk for this condition. During growth spurts, the muscles and bones develop rapidly, which may contribute to short-term muscle imbalances.

Gender: Females are at greater risk than males to develop runner’s knee, as they typically possess less muscle mass than males. This can cause abnormal knee positioning, as well as more lateral (side) pressure on the kneecap.

Flat feet: Having flat feet may place more stress on the knee joints than having higher arches would.

Previous injury: A prior injury to the kneecap, such as a dislocation, can increase your risk of developing runner’s knee.

High levels of activity: If you have a high activity level or engage in frequent exercises that place pressure on your knee joints, this can increase the risk for knee problems.

Arthritis: Runner’s knee can also be a symptom of arthritis, a condition causing inflammation to the joint and tissue.

Diagnosis of Chondromalacia Patellae

Your Podiatrist will look for areas of swelling or tenderness in your knee. They may also look at how your kneecap aligns with your thigh bone. A misalignment can be an indicator of chondromalacia patellae. Your Podiatrist may also apply resistive pressure to your extended kneecap to determine the tenderness and severity.

Afterward, your Podiatrist may request any of the following tests to aid in diagnosis and grading:

· X-rays to show bone damage or signs of misalignment or arthritis

· Magnetic Resonance Imaging (MRI) to view cartilage wear and tear

· Arthroscopic exam, a minimally invasive procedure to visualize the inside of the knee that involves inserting an endoscope and camera into the knee joint

This article is excerpted from：The Foot and Ankle Clinic.

https://www.thefootandankleclinic.com.au/condition/chondromalacia-patellae/