Brief Outline of Chondromalacia Patellae (Runner’s Knee)
Softening and degeneration of the articular cartilage of the patella (knee cap) in athletes is usually a result of overuse, trauma, or abnormal forces on the knee. In older adults it can be a result of degenerative arthritis. Pain under the knee cap and a grating sensation when the knee is extended are possible signs of this condition.
Anatomy and Physiology of Chondromalacia Patellae (Runner’s Knee)
The underside of the patella is protected by articular (hyaline) cartilage, which is made up of collagen fibres and water. The cartilage can become damaged and softened by repetitive micro-trauma due to overuse or abnormal load bearing on the knee. This degeneration makes the surface rough instead of its usual smooth surface which causes additional inflammation and pain. Generally described in four progressive stages, from softening and blistering, to full cartilage defects and subchondrial bone exposure.
Cause of Chondromalacia Patellae (Runner’s Knee)
Repetitive micro-trauma to the cartilage through overuse conditions. Misalignment of the knee cap. Previous fracture or dislocation of the knee cap.
Signs and Symptoms of Chondromalacia Patellae (Runner’s Knee)
Pain that worsens after sitting for prolonged periods or when using stairs or rising from a seated position. Tenderness over the knee cap. Grating or grinding sensation when the knee is extended.
Complications if Left Chondromalacia Patellae (Runner’s Knee) Unattended
Cartilage that degenerates and becomes rough can cause scarring in the bone surface it rubs against. This in turn cause more inflammation. Cartilage can also be torn when it is rough leading to loose bodies in the joint.
Immediate Treatment for Chondromalacia Patellae (Runner’s Knee)
Rest and ice. Anti-inflammatory medication. Synvisc injection.
Rehabilitation and Prevention of Chondromalacia Patellae (Runner’s Knee)
Limiting activity until the pain subsides and gradually re-entering the activity is important. Strengthening and stretching the quadriceps is important to relieve pressure on the patella. Activities that increase the pain, such as deep knee bending, should be avoided until completely pain free. Avoid abnormal stress on the knee, and keep the hamstrings and quadriceps strong and flexible to prevent this condition.
Long-term Prognosis for Chondromalacia Patellae (Runner’s Knee)
Chondromalacia patellae commonly responds well to therapy and anti-inflammatory medication. In rare cases, surgery may be required to correct a misalignment in the knee cap.