The patella, also called the kneecap is a small bone present on the front of your knee joint. The underside of the patella is covered by cartilage that allows smooth gliding of the knee with movement. Overuse or misalignment of the patella can cause wear and tear of the cartilage.
Patellofemoral chondromalacia is a common condition characterized by softening, weakening and irritation of the cartilage. The condition is most often seen among young athletes and older adults who have arthritis of the knee. It is especially seen in women.
There is no explicit reason why the cartilage irritation occurs. However, it is associated with improper knee alignment or imbalance in the tightness of the muscles holding it in place. Overuse of the knee in certain sports activities may cause wear and tear of the cartilage. This may cause rubbing or grinding of the kneecap against the bone instead of it smoothly gliding over the knee joint.
Patellofemoral chondromalacia may also be caused due to injuries such as fractures or dislocations or may develop as a part of your ageing process.
Patellofemoral chondromalacia is the most common cause of knee pain. Called patellofemoral pain, it is characterized by the following:
- Pain in front, around or behind your knee
- Pain that gets worse when climbing up or down the stairs, sitting or standing for long periods, or when extreme pressure is applied on the knee
Other symptoms may include:
- Grinding or cracking sensation or noise when you move your knee
- Rarely, swelling or fluid effusion in your knee joint
Dr. Patel will conduct a physical examination by applying pressure on different areas of your knee and moving your leg in different positions. You may be asked to undergo imaging tests including an X-ray, CT scan and MRI scan to obtain detailed images of the bones and soft tissues of the knee.
The treatment of patellofemoral chondromalacia initially involves simple conservative procedures. You may be asked to rest your knee and avoid any activity that may strain the knee joint. Dr. Patel may prescribe anti-inflammatory drugs to relieve pain and reduce swelling. Physical therapy will be the key to help you to improve the muscle strength, decrease stress on your knee and aid in correcting the misalignment. Wearing support braces and taping around the knee may help you protect your joint, reduce pain and improve alignment. Application of ice on the knee may be recommended after exercise.
When non-surgical treatment does not relieve pain, Dr. Patel may recommend surgical treatment. Surgery may involve:
- Arthroscopy: Dr. Patel inserts a device called an arthroscope (thin tube with a camera and light attached) through a small incision. This helps to clearly view the surgical site while other instruments are inserted to remove fragments of the damaged cartilage.
- Realignment: Dr. Patel may operate on your knee to realign the position of your kneecap and release the pressure over the cartilage.
Dr. Patel will examine your condition and provide you with best treatment option.