Chondromalacia patella is a condition where the articular cartilage on the underside of the kneecap (patella) softens and breaks down. This cartilage is supposed to be smooth and slippery to help the patella glide over the thigh bone (femur). When it becomes frayed or thinned, the resulting friction leads to inflammation and pain in the front of the knee.
The symptoms are generally related to activities that increase "patellofemoral" compression—the pressure between the kneecap and the femur.
Frontal Knee Pain: A dull, aching pain behind or around the kneecap.
Pain with Stairs: Discomfort that intensifies when climbing or, more commonly, descending stairs or hills.
Crepitus: A grinding, clicking, or crunching sensation felt or heard when straightening the leg.
"Movie Theater Sign": An ache that sets in after sitting for a long time with the knees bent (like in a car or theater).
Mild Swelling: Occasional puffiness around the kneecap area after physical exertion.
Diagnosis focuses on identifying the grade of cartilage wear and underlying causes, such as poor muscle balance or alignment issues.
Physical Examination
X-rays: Used to view the alignment of the kneecap within its groove (the trochlea) and to check for bone spurs.
MRI: The gold standard for visualizing the grade of cartilage softening and identifying specific areas of thinned tissue.
Most cases are managed successfully without surgery by improving how the kneecap "tracks" in its groove.
Activity Modification: Swapping high-impact running or jumping for low-impact options like swimming or cycling.
Physical Therapy: Strengthening the VMO (inner quad) and hip abductors to pull the kneecap into better alignment.
Patellar Taping or Bracing: Using Kinesio-tape or a sleeve with a "donut" buttress to stabilize the patella.
Orthotics: Using shoe inserts if flat feet (overpronation) are causing your leg to rotate inward and pull the kneecap out of alignment.
NSAIDs: Over-the-counter anti-inflammatories to reduce the chemical irritation within the joint.
Arthroscopy: A surgical procedure (chondroplasty) to smooth down frayed cartilage and flush out debris.