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The leading cause of chondromalacia patellae, also referred to as “runner’s knee,” is the softening of the cartilage in the kneecap. Although older adults with knee arthritis may also experience it, young athletes frequently do.
Chondromalacia is frequently regarded as an overuse injury in sports, so taking a few days off from training is occasionally beneficial. In other cases, poor knee alignment is to blame, and resting is ineffective. Runner’s knee symptoms include knee pain and a grinding sensation, but many patients never go to the doctor.
Chondromalacia patellae (CMP) is a condition that causes structural and biomechanical changes that cause anterior knee pain. Sclerosis of the underlying bone and softening, swelling, fraying, and erosion of the hyaline cartilage beneath the patella are symptoms of degenerative changes occurring in the articular cartilage on the posterior surface of the patella.
Chondromalacia patellae is one of the most frequently occurring causes of anterior knee pain in young people. It can affect up to one in four people, making it the most common cause of death in the US. The word “chondromalacia” combines the Greek words Chronos, which means cartilage, and malaria, which means softening. Consequently, chondromalacia patellae is a softening of the articular cartilage on the patella’s posterior surface, which may eventually lead to fibrillation, fissuring, and erosion.
Additional diagnoses of chondromalacia include patellofemoral pain syndrome and patellar tendinopathy. Chondromalacia is not thought to be a part of PFPS in general. Since it is thought that the pathophysiology is different, there is an alternative treatment.
Four stages describe the severity of a runner’s knee, ranging from Stage 1 to Stage 4. The least severe stages are Stages 1 and 4, respectively.
Depending on the degree, the cartilage in the knee is softening.
Signals both abnormal surface characteristics and a softening of the cartilage. It is usually the beginning of tissue erosion.
Shows active tissue deterioration and thinning of the cartilage.
The most serious Stage is defined as the exposure of the bone and a sizable amount of deteriorated cartilage. There is likely bone-to-bone rubbing when there is bone exposure in the knee.
A dull, aching pain in the front of the knee is the most typical sign of patellofemoral pain syndrome. The following things can make it worse:
All four examination techniques—observation, mobility, feel, and X-ray—are used to assess the knee.
Exercise and education are two of a treatment program’s most essential elements. Education enables the patient to fully understand their condition and the best ways to take care of it for a quick recovery. The appropriate structures, such as the gluteal muscles, quadriceps, and hamstrings, are lengthened and strengthened through exercises. The biodynamic structure of the patellae can be restored with acupuncture and fire needling, which can also help treat the clinical symptoms and signs of chondromalacia patellae.
If conservative measures fail, a variety of surgical options are available.
Two additional treatments that may be successful are:
Only removing cartilage will not cure chondromalacia patellae. The biomechanical deficiencies, which must be addressed, can be managed using several techniques.
Although there is no single method for treating chondromalacia, most medical professionals concur that non-surgical treatment is the best choice.
Physically, it is strongly suggested to use conservative treatment for chondromalacia patellae. Short-wave diathermy can assist in reducing discomfort and enhancing local blood flow, enhancing the nutrient supply to the articular cartilage. Care must be taken when organizing an exercise program. Examples of traditional therapeutic approaches include the following:
The program should include both strengthening and stretching. Hamstring length and flexibility are lower in patients with patellofemoral pain syndrome than in those without symptoms. While stretching can improve knee flexibility and function, pain relief is not always immediately achieved.
Another treatment method involves warm needling. Coupled with therapeutic exercises, it provides pain relief that lasts longer than warm needling and medication alone.
The use of ice during an acute flare-up may help to reduce pain, but it should not be a long-term treatment option. NSAIDs may be useful for pain relief in the short term to resume normal knee function and mobility and begin an exercise regimen.
Although there is conflicting evidence, taping the patella to restrict its movement might provide some short-term relief. Many people use a method called “McConnell taping” or “kinesio taping.”
Bracing the patella and knee joint is another method for reducing symptoms and pain. However, the patella’s tracking will be altered, and the quadriceps’ capacity for active contraction will be reduced. Bracing may be beneficial in the short term to give patients support and pain relief to prevent arthralgic movements and maintain a gait as close to normal as possible. Before and following surgery patients can wear braces before and after surgery, but the brace should allow for some variation in the pressure and medial pull on the patella. Physical therapy and the use of a patellar realignment brace are beneficial for patients with chondromalacia patellae.
Foot orthoses are a different pain-relieving option, but they should only be considered when it is determined that improper lower limb mechanics are the root of knee pain. It might be the situation if
Foam rolling can be beneficial by releasing tight muscles and relieving pressure on the patella.