Is your knee pain from Chondromalacia Patella?

The patella, also known as the knee cap, is an important component of the knee joint. The main function is to accommodate the angle for the quadricep muscles to straighten out the knee (extension). In addition, the patella protects the front aspect of the joint and assists in smooth function during flexion and extension of the knee.

The patella is covered in articular cartilage where the bones meet. Similar to the femur (thigh bone), and tibia (shin bone), for instance. The surrounds surface of the patella is susceptible to damage from injuries, patella instability, arthritis, overuse, or infection- and the cartilage softens and breaks down. In other words, chondromalacia patella is the name for this ailment.

Chondromalacia Patella can present with the following symptoms:

  1. A dull aching behind and/or around the knee cap
  2. Pain increases going up or down stairs
  3. Grinding sensation with knee extension
  4. Pain with sitting for long periods of time
  5. Swelling and inflammation
  6. A catching sensation or the feeling of buckling of the knee
  7. Pain with kneeling or squatting

Diagnosis and Prognosis

With obtaining a medical history and physical evaluation your doctor may ask for x-rays or MRI’s to get a visual the knee. Although rare, Arthroscopic surgery is needed to properly diagnosis the problem. Other ailments can cause similar symptoms and need to be ruled out appropriately.

Treatment plan will depend on the severity of the cartilage damage. Mild damage might respond well to conservative treatments, for instance. Physical therapy, anti-inflammatory medications and using ice can reduce symptoms. Likewise, proper footwear, braces, and simply losing weight can alter the positioning of the patella and relief pain.

Chondromalacia patella is be quite common in adolescents. Treatment is limited to symptom management until their bones are finished growing.  It is not unusual for the treatment to last anywhere from months to years. In older adults however, chondromalacia patella is often more advanced and irreversible, and surgery is required to provide relief.

Surgical Interventions

It is important to note that cartilage does not heal itself well. Therefore, in cases where the symptoms can not be controlled conservatively, surgery is an option.

Arthroscopic surgery is minimally invasive form of surgery that uses an arthroscope through a small incision. Likewise, surgical instruments are also used through small incisions. Depending on your age, history, and the cause of the condromalacia patella these surgeries can be an option:

  1. Arthroscopic Debridement
  2. Lateral Release of Tissue
  3. Osteotomy to adjust pressure in the joint
  4. Microfracture and Osteochondral Autografts to treat cartilage defects

Severe damage to patellar cartilage and advanced osteoarthritis can require joint replacement surgery. In this procedure, damage contained to the surface of the patella is removed and replaced with a smooth prosthetic surface. In many cases, however, osteoarthritis is present throughout the entire knee joint, and the patient will require a partial or total knee replacement.

Simply removing the patella is typically not a good course of action. Without the essential part of the knee the joint might be unable to extend fully. Secondly, it will have instability and higher risk of buckling and weakness.

Do you suffer from knee pain? The Heekin Clinic can help you be on your way to less pain and better mobility. Contact us today to schedule an appointment.

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