Runner's Knee (Chondromalacia Patella)

Chondromalacia patella is a chronic condition causing softening and breakdown of the articular cartilage on the underside of the patella, or knee-cap. 

 

Symptoms

• Pain in front of knee and under patella

• Grinding or clicking in the knee when bending and extending knee

• Pain with prolonged sitting or prolonged standing

 

Causes

• Overuse

• Poor patellar tracking/alignment in the patellar groove

• Direct blow to knee below patella

• Repeated stress from running, jumping, squatting activities

• Muscular imbalance in upper legs

 

Risk factors

• More often found in females than males 

• Most often seen in young adults

• Individuals with a high activity level (especially running, jumping, squatting)

• Previous injury to the knee such as dislocation

• Adolescents going through a growth spurt

• Flat feet or knock-kneed

 

Prevention

• Avoid repeated stress to patella or activities that cause pain

• Wear knee-pads if extended time kneeling

• Fix muscular imbalances by strengthening quadriceps, hamstrings, adductor, and abductor muscles

• Orthotic shoe inserts to correct poor alignment of feet

• Maintain a healthy weight

 

Diagnosis

• Physician examination will look for inflammation and tenderness around the patella

• Physician will watch patellar tracking and gait (how an individual walks)

• X-ray may better show patellar alignment and tracking

• MRI to assess cartilage damage 

 

Treatment options

Non-surgical:

• R.I.C.E

• Brace to improve patellar tracking

• Reduce pressure on patella

• Non-steroidal anti-inflammatory medication

• Physical therapy to strengthen quadriceps muscles and correct muscular imbalances

 

Surgical:

• Arthroscopy- to assess joint and debridement of undersurface of patella

• Lateral release- if malalignment noted and not fixed by conservative measures

• Smoothing of undersurface of patella and implanting a cartilage graft