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Chondromalacia patella is a condition
caused by the degeneration or erosion of cartilage under the surface of the kneecap,
creating an irritation or pain within the joint. As the protective cartilage wears away, the kneecap and the femur (upper leg bone)
begin to come in contact with one another, making the knee difficult
to move without pain.
This condition can vary in severity, depending on the location and
the amount and rate of degeneration of the cartilage.
Heredity, intensity of athletic activity and the extent of previous
injury to the knee all play a role in determining the amount
of degeneration to the cartilage.
The damaged cartilage cannot be re-grown. Treatments can
supplement the remaining cartilage, but these are still temporary
measures to protect the knee against further deterioration of
the cartilage.
Less advanced conditions are treatable with physical therapy and
other non-surgical treatments. Patients with severe conditions may require surgery. This surgery removes the damaged cartilage and creates a cartilage-like substitute in the area of the cartilage defect.
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Continual discomfort and irritation located behind the kneecap or
throughout the front of the knee.
Pain while extending the leg or while walking or running.
Particularly strong pain while climbing or descending stairs or
during movements that place considerable force on the front of the knee.
Discomfort or pain after sitting or keeping the knee motionless in a flexed position for an extended period of time.
A feeling or sensation of grinding, popping or snapping in the knee during motion.
Usually, the more advanced the condition, the more severe the pain in the knee.
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The patient has the signs and symptoms of chondromalacia patella.
After treatment, the patient experiences increasing pain or weakness in the joint.
The patient experiences unexplained symptoms, other types of pain or unexpected side effects of medication.
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Chondromalacia patella results from a combination of factors
including heredity, intensity of athletic activity and the
extent of previous injury.
Repetitive actions which impact or stress the knee can cause additional damage over time.
Over-pronation of the foot, which causes the lower leg to
rotate inward, can accelerate the erosion, softening or degeneration of the
cartilage. In this position, the kneecap is pushed to the
outside which results in increased pressure and improper wear
of the kneecap.
If the patient has weak thigh muscles, the kneecap is less likely
to be held in its proper position during athletic activity, leading to
increased wear on the underside of the kneecap.
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Recovery times for chondromalacia patella can vary according to the severity of the condition.
If the erosion or softening of the cartilage is minor, physical therapy minimizes symptoms after motion in the joint is restored and the surrounding muscles are conditioned.
Patients with severe symptoms, which require surgery, can expect a lengthy recovery. Following surgery, most patients are allowed to bear weight as tolerated, but flexion of the knee is usually limited by the surgeon for four to six weeks. Ongoing physical therapy, combined with modification to previous athletic activities, will likely be required for more than three months.
To help maintain a healthy knee, continued gentle use of the knee will be required. A reduction in other impact producing activities is recommended.
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About the Clinical Review Team
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