Chondromalacia : What is it?

Chondromalacia patella is a very very common diagnosis — and a very common cause of knee pain in young women and in runners of all ages.

Chondromalacia  is also a very common reason why our knees click or grind.

What is Chondromalacia:

Normal Patella Cartilage without Chondromalacia

Chondromalacia, very simply put represents a softening and early degenerative process involving the cartilage on the underside of your kneecap or patella.  It is more common in woman, some as young as teenagers. Cartilage is a very important structure in our knee.  It coats the ends of all the bones in our knee which touch – or articulate- on one another.  It allows free motion without friction, pain, clicking or discomfort.  If the cartilage begins to degenerate or change then our knee might hurt, it might click and some patients with chondromalacia or cartilage changes might have a feeling of “catching” or giving way. Most people with knee pain due to chondromalcia experience difficulties or pain when arising from a seated position, or when climbing or going downstairs.

Normal cartilage in our knee is usually quite firm, and absolutely smooth with no divots, fissures or roughness.  When chondromalacia sets in, the cartilage surface starts to degrade or degenerate.  That means that the cartilage begins to soften, develop fissures, torn flaps, becomes thinner than usual — and on occassion progresses to frank osteoarthritis.

The exact cause of chondromalacia is unknown.  In many people, the cartilage on the patella or kneecap simply begins to degenerate.  Potential causes of chondromalacia include genetic predisposition, prior trauma, repetitive stress (very common condition in runners) … or in the majority of cases we’re not sure why it has occurred.  I have seen entire families with chondromalacia in exactly the same area under the patella… supporting the genetic cause. Yet, I have seen some patients with extended families, no history of trauma, and they are the only ones who have severe chondromalacia.  Some recent evidence points to the fact that vitamin D defiiciency might also predispose you to developing chondromalacia or early osteoarthritis.

Notice the fissures and irregularity of the cartilage surface.

 Treatment Options for Chondromalcia:

The treatment for chondromalacia depends to a large degree on whether or not it is the cause of your pain.  Not everyone with chondromalacia has pain.  In cases of mild chondromalacia, with minimal cartilage damage, physical therapy and exercises to strengthen the muscles supporting your kneecap can be very effective.  If you are a runner and experience pain in the front of your knee, minimizing hill running, changing your running technique (toe vs heel runners) can be effective as well.  On occasion we might inject someone who is very uncomfortable and their knee is swollen and very painful.  We have a number of medications or supplements that can be injected depending on your personal situation.

Can Chondromalacia be Cured?

Sadly, no. But most patients lead very active lives despite their chondromalacia once a treatment regimen is started.

Can Chondromalcia be treated?

YES!   There are many treatments and remedies to help minimize the pain and knee discomfort associated with chondromalcia.  Exercises, medications, therapy, and rarely surgery can help minimize your discomfort associated with chondromalacia and let you lead a happy life in minimal discomfort.

Further questions?

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