Chondromalacia Patella

Chondromalacia patella is a condition characterized by the softening and breakdown of the cartilage on the underside of the kneecap (patella). This cartilage damage causes the kneecap to rub against the thighbone (femur) during movement, leading to pain, inflammation, and a grinding sensation.

The condition is particularly common in young, active individuals and is often related to improper tracking of the kneecap, similar to patellofemoral pain syndrome. Over time, if left untreated, chondromalacia can progress to more significant cartilage damage and potentially contribute to knee arthritis.

At Mountain Spine & Orthopedics, our knee specialists use advanced imaging including MRI to assess the extent of cartilage damage and create a personalized treatment plan focused on correcting biomechanics and preserving the remaining healthy cartilage.

• Front-of-knee pain around or behind the kneecap
• A grinding or crunching sensation when bending or straightening the knee
• Pain that worsens with activities like climbing stairs, squatting, or sitting for long periods
• Swelling around the kneecap (in some cases)
• Stiffness, especially after periods of inactivity
• Pain that may be described as aching or sharp, depending on activity
• Difficulty with activities that require knee bending

Several factors increase the risk of developing chondromalacia patella:

• Muscle imbalances, particularly weak quadriceps or tight hamstrings
• Improper tracking of the kneecap due to structural or biomechanical issues
• Overuse from repetitive activities, especially running or jumping
• Previous knee injuries that may have altered kneecap mechanics
• Certain anatomical factors, such as a shallow patellar groove or misaligned kneecap
• Flat feet or other foot problems that affect knee alignment
• Sudden increases in activity intensity

Diagnosis begins with a comprehensive physical examination to assess kneecap alignment, movement, and any grinding sensations. Our specialists evaluate muscle strength, flexibility, and movement patterns that may contribute to the condition.

We offer a complimentary MRI review, as MRI is the best imaging method for visualizing cartilage damage on the underside of the kneecap. X-rays may also be used to assess kneecap alignment and rule out other conditions.

Non-Surgical Treatment Options

Initial treatment focuses on physical therapy referrals to strengthen the quadriceps muscles (particularly the vastus medialis), improve flexibility, and correct biomechanical issues. Activity modification to reduce stress on the kneecap is also important.

Injection or Interventional Care

For patients with persistent pain, corticosteroid injections may provide temporary relief. Biologic injections like PRP or stem cell therapy may help stimulate cartilage healing in some cases, though results vary.

Surgical Treatment Options

When conservative measures fail or cartilage damage is significant, surgical options may be considered. These include arthroscopic procedures to smooth damaged cartilage or realignment procedures to correct patellar tracking, performed using minimally invasive techniques. In advanced cases, cartilage restoration procedures may be considered.

Chondromalacia patella pain is typically felt in the front of the knee, around or behind the kneecap. The pain is often described as a dull ache that worsens with activities that stress the patellofemoral joint, such as climbing stairs, squatting, or running.

Many patients experience a grinding or crunching sensation when bending or straightening the knee, which is caused by the damaged cartilage rubbing against the thighbone. The pain is often worse going down stairs than up, and may be particularly noticeable after prolonged sitting. Our comprehensive treatment approach addresses both the cartilage damage and the biomechanical issues that contribute to it.

Several strategies can help prevent chondromalacia patella or slow its progression:

• Maintaining strong quadriceps muscles, particularly the vastus medialis
• Improving flexibility in the hamstrings, calves, and IT band
• Using proper running and jumping techniques
• Gradually increasing activity intensity to avoid overuse
• Wearing appropriate footwear and using orthotics if needed
• Addressing muscle imbalances through targeted exercise
• Seeking early evaluation from a knee specialist when symptoms first appear

If you're experiencing front-of-knee pain with grinding sensations, schedule a consultation with Mountain Spine & Orthopedics today. Benefit from a complimentary MRI review and expert evaluation to determine the best treatment approach. Same-day and next-day appointments are often available.