Chondromalacia Patellae Treatment In New Jersey

Understanding the anatomy of the knee is crucial to understanding chondromalacia patella(e). The knee joint is composed of several different bones, one of which is the patella (kneecap). The back of the patella is covered by a tough, rubbery tissue called articular cartilage; this protects the kneecap from rubbing against your femur, another leg bone that forms part of the knee joint, as it moves around.

Over time, this articular cartilage can wear away, causing the tips of your femur and patella to rub against each other. This can cause knee pain and tenderness as well as grinding sensations in the area.

If you’re experiencing pain or discomfort as a result of chondromalacia patella(e), the doctors at Modern Orthopaedics of New Jersey can help. 

Causes of Chondromalacia Patellae

The knee is a complex joint, composed of tendons, ligaments, muscles, and bones. Dysfunction in these components can lead to chondromalacia patella. Given the complexity of the knee joint, there are many potential causes of chondromalacia patella, including:

• Trauma to the patella (kneecap)
• An imbalance in the muscles around the knee
• Poorly aligned muscles around the knee, especially due to congenital conditions
• Arthritis and osteoarthritis
• Infections
• Repeated stress to the knee joints

Repeated stress is the most common cause of chondromalacia patella; it’s most often caused by activities like running, jogging, skiing, and cycling. For this reason, chondromalacia patella is often called runner’s knee. Manual labor, including carpet and floor laying, as well as tile setting, can also cause chondromalacia patella.

Young athletes are particularly prone to developing chondromalacia patella. 

Identifying Symptoms

The most common symptoms of chondromalacia patella are:

• Pain behind the kneecap
• Grinding and cracking sensations when bending or extending the knee
• Pain and discomfort that flare up when you go up or down stairs, or when your knee is in the same position for a long period of time
• A knee joint that catches or buckles, especially after bending it repeatedly
• Grinding and creaking sounds when the knee is moved

Any of these symptoms can be a sign that you have chondromalacia patella, though they can also be signs of other knee conditions. It’s important to visit a medical professional should you develop these symptoms, especially if they persist over long periods of time. 

Diagnosis Process

The first step in diagnosing chondromalacia patella is a detailed overview of your medical history. Your doctor will want to know if you have had any surgeries, sprains, fractures, bleeding, or infections in the knee. They’ll also ask if you’ve been diagnosed with arthritis, what you do for work, and whether or not you’re involved in athletics or other recreational activities.

From there, your doctor will perform a physical exam. This may include:

• Checking the knee for swelling and tenderness
• Looking for a misalignment in the kneecap
• Applying pressure to your kneecap when it is extended to check for discomfort or pain
• Articulating (bending and straightening) the knee to check for creaking sounds and grinding sensations

Once the physical exam is completed, your doctor may perform additional tests. These may include:

• MRIs to check for wear and tear in the articular cartilage
• X-rays to check for misalignment, arthritis, or other conditions that could be affecting the knee
• Arthroscopic exam—a minimally invasive surgery to get a better look at the cartilage and knee joint

These diagnostic procedures can help your doctor determine whether or not you have chondromalacia patella or another condition. There are several different conditions that can cause pain in the patella—patellofemoral pain syndrome (PFPS) is another such condition. Patellofemoral pain syndrome is also sometimes called runner’s knee, which can lead to some confusion.

Chondromalacia Patellae Treatment Approach

When your doctor diagnoses your chondromalacia patella, they will also assign it a grade. Here’s how grading works:

• Grade 1 means there’s some softening in the cartilage of the knee.

• Grade 2 indicates surface fraying or other defects affecting less than 50% of the cartilage’s thickness.

• Grade 3 shows more active deterioration of the cartilage.
• Grade 4 means there is bone exposure, which typically leads to bone-to-bone contact.

Your doctor’s approach to treatment will depend heavily on the grade of your chondromalacia patella. Physical therapy, lifestyle modifications, preventive measures, and surgical interventions may be used, depending on the level of wear. 

Physical Therapy: Foundation of Recovery

Physical therapy is typically the first step in the treatment of runner’s knee, before any more intensive or surgical interventions. The goal of physical therapy is to strengthen the muscles around the knee, as well as to increase their flexibility. Doing so can help prevent knee misalignment. 

You should only begin physical therapy once the pain and swelling have subsided. To reduce pain and swelling, your doctor may:

• Recommend applying ice to the affected area
• Recommend nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for pain relief and to reduce swelling
• Recommend other pain relief medications
• Recommend you cease activities that could aggravate the condition

Once pain and swelling have subsided, your physical therapist can begin offering exercises and other interventions to strengthen your knee and the muscles surrounding it. 

Physical Therapy Interventions

Physical therapy may start with non-weight-bearing exercises—swimming is often recommended to keep the patient in shape. Later, isometric exercises like straight leg raises may be used to strengthen muscles like the quadriceps.

Your physical therapist may also recommend manual therapeutic techniques, which may include soft tissue massages and joint mobilization techniques. 

Other interventions, like using knee tape or a knee brace, may be introduced at this stage to keep the patient’s kneecap aligned. 

Medical Interventions for Chondromalacia Patellae

At times, especially when the chondromalacia patella is higher grade, more intensive medical interventions might be necessary. A variety of different surgical options are available, depending on the circumstances. These options include:

• Lateral release surgery
• Chondroplasty (the reshaping and repair of damaged cartilage)
• Cartilage grafts

Lifestyle Modifications and Preventative Measures

The best way to treat chondromalacia patella is to prevent it from happening altogether—and once it happens, to prevent it from worsening. You can do this by:

• Avoiding repeated stress to your kneecaps
• Wearing kneepads when spending a lot of time on your knees
• Ensuring that you’re wearing the right footwear, and using shoe inserts where necessary
• Focusing on strengthening and flexibility exercises
• Focusing on proper form when running, skiing, or using your knees in other ways
• Resting and listening to your body when there are early warning signs of runner’s knee

Expert Care in New Jersey

When you’re suffering from knee pain, you only have one focus—getting healthy again. The doctors at Modern Orthopaedics of New Jersey are here to help. Our doctors will help get you moving again, with state-of-the-art diagnostic tools and techniques, expert recommendations, and surgery—when needed.

There is relief for knee pain. Book an appointment with us today.