Chondromalacia Patellae (Runner’s Knee)
- Pain located at front of knee or under kneecap (especially when going up or down stairs)
- Grinding or grating in knee during movement
- Swelling and tenderness in and around the knee
What is Chondromalacia Patellae (Runner’s Knee)?
Chondromalacia Patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes. Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.
Chondromalacia is due to changes of the deepest layers of cartilage, causing blistering of the surface cartilage. The pattern of cartilage damage seen with Chondromalacia is distinct from the degeneration seen in arthritis, and the damage from Chondromalacia is thought to be capable of repair, unlike that seen with arthritis.
Chondromalacia is interesting in that it often strikes young, otherwise healthy, athletic individuals. Women are more commonly affected with Chondromalacia. Exactly why this is the case is unknown, but it is thought to have to do with anatomical differences between men and women, in which women experience increased lateral forces on the patella.
The treatment of Chondromalacia remains controversial, but most individuals can undergo effective treatment by resting the knee and adhering to a proper physical therapy program. Allowing the inflammation of Chondromalacia to settle is the first step of treatment.
Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee.
The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the quadriceps and hamstring muscle groups. Use of non-steroidal anti-inflammatory medication is also helpful to minimize the pain associated with Chondromalacia. Treatment with surgery is declining in popularity for two reasons: good outcomes without surgery, and the small number of patients who actually benefit from surgical treatment.
Diagnosis Using Knee Arthroscopy
Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, still requires the use of anesthetics and the special equipment in a operating room or outpatient surgical suite. You will be given a general, spinal, or a local anesthetic, depending on the joint or suspected problem.
A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Several other incisions may be made to see other parts of the joint or insert other instruments.
After arthroscopic surgery, the small incisions will be covered with a dressing. You will be moved from the operating room to a recovery room. Many patients need little or no pain medications.
The amount of surgery required and recovery time will depend on the complexity of your problem. Occasionally, during arthroscopy, the orthopaedic surgeon may discover that the injury or disease cannot be treated adequately with arthroscopy alone. The extensive “open” surgery may be performed while you are still anesthetized, or at a later date after you have discussed the findings with your surgeon.
Lateral release is a surgical procedure performed to release the lateral retinaculam on the lateral aspect of the kneecap. If this tightness is causing the patella to not track properaly over the knee joint and it is causing pain, your surgeon may recommend a procedure called a lateral release to cut the ligament. This is most often done with arthroscopic surgery, which results in a much quicker and less painful recovery time.
Contact Orthopaedic Specialists, Inc.
If you would like to learn more about our minimally invasive treatment options, please schedule a consultation at our practice, and one of our fellowship-trained specialists will help you find the best solution for your knee symptoms by calling (563) 344-9292