Introduction
What is patella chondromalacia?
The knee joint is formed where the ends of the femur (thigh bone), tibia (shin bone), and patella (kneecap) join together. Covering these bony surfaces where they articulate with one another is a layer of shiny and slippery connective tissue known as articular cartilage. Over time, this cartilage can wear with natural aging or sustain damage from a traumatic event. Patella chondromalacia, otherwise known as “Runner’s Knee,” causes the cartilage on the underside of the patella to deteriorate and soften. Young, active individuals are often affected by this condition, but it can also occur in older individuals with knee arthritis. Dr. Frank McCormick, orthopedic knee specialist serving Orlando, West Palm Beach County, and surrounding Florida communities, has the knowledge and understanding, as well as substantial experience, in treating patients with patella chondromalacia.
Are there risk factors for developing Runner’s Knee?
Individuals with a patella dislocation frequently complain of severe knee pain accompanied by rapid, acute inflammation. On occasion, this pain and swelling may result in the patella returning to its correct anatomical position. Some other common symptoms of a patellar dislocation include:
- Age and Activity Level: Younger and more active individuals have a higher likelihood of developing Runner’s Knee.
- Anatomy: Flat feet can increase the stress on the knee joints thereby making individuals more susceptible to premature cartilage breakdown.
- Gender: Due to their lower muscle mass, women tend to develop Runner’s Knee more often than men.
- Previous Injury: Damage to the cartilage from a previous knee injury can cause acceleration in the breakdown of cartilage.
What are the symptoms of patella chondromalacia?
Individuals with patella chondromalacia often report knee pain localized over the front of the knee joint. This pain may be exacerbated after sitting or standing for an extended period of time or after physical activities that increase stress on the knee joint. Some patients describe a “cracking” or “grinding” sensation with extending or bending the knee joint.
How is Runner’s Knee diagnosed?
A thorough physical examination of the knee joint will be performed by Dr. McCormick after obtaining an in-depth medical history, including physical activity habits. The knee joint will be evaluated for areas of tenderness and swelling as well as alignment of the bones. Patellar malalignment can be a positive indicator of Runner’s Knee. The diagnosis of patella chondromalacia, or Runner’s Knee, is commonly made on the basis of a physical examination and medical history; however, diagnostic imaging tools such as x-rays and magnetic resonance imaging (MRI) may be ordered to rule out damage to other structures within the knee joint.
Dr. McCormick will review the physical examination and diagnostic imaging studies to grade the Runner’s Knee into one of four categories. Grade 1 shows minimal wear of the cartilage; Grade 2 also exhibits cartilage wearing with additional abnormal tissue characteristics; Grade 3 shows active cartilage deterioration; and, Grade 4, the most severe, shows exposure of the underlying bone with substantial cartilage degeneration.
What is the treatment for patella chondromalacia?
Dr. McCormick will review several patient factors such as age, medical history, and activity level to formulate a treatment plan that best addresses the patient’s specific needs.
Non-surgical treatment:
Patients diagnosed with Grades 1 and 2 patella chondromalacia are likely to benefit from conservative therapies alone. Conservative treatments aim to minimize the stress placed on the knee joint. This can be accomplished through any combination of rest, ice, joint stabilization, and non-steroidal anti-inflammatory medications (NSAIDs). A physical therapy program is also beneficial for improving muscle strength and balance.
Surgical treatment:
Patients with more substantial cartilage damage, such as Grades 3 and 4 patella chondromalacia, or those who failed to respond to conservative therapies may require surgical intervention. Dr. McCormick favors an arthroscopic surgical approach when treating Runner’s Knee as this minimally invasive technique uses a small camera (arthroscope) and specialized surgical instruments to examine the knee joint structures. Based on the findings from this visual examination, Dr. McCormick will implement one of several available repair techniques to repair the patellar cartilage.
The technique most often performed for patella chondromalacia is a lateral retinaculum release. The lateral retinaculum, a fibrous tissue near the patella, is severed to alleviate tension and reposition the patella. Other surgical options may involve cartilage graft implantation, smoothing the cartilage on the underside of the patella, or transferring the insertion site of the thigh muscle.
For more information on patella chondromalacia, or the excellent treatment options available, please contact the office of Frank McCormick, MD, orthopedic knee specialist serving Orlando, West Palm Beach County, and surrounding Florida communities.
