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Joints throughout the body – including the knees – are lined with a tissue called articular cartilage that allows the bones within the joint to move smoothly against each other while cushioning them during impacts. Over time, or because of an acute injury, that cartilage can begin to soften and break down in a condition called chondromalacia. The cartilage’s ability to protect the bones within the joint is then reduced, resulting in pain.

While chondromalacia can happen in any joint in the body, it is most commonly encountered on the underside of the kneecap, in a condition called chondromalacia patella. As the cartilage degrades, it can come apart and form a fibrous mass, or can even wear down completely, painfully exposing the patella’s bony surface to the other bones in the knee.

Common Causes for chondromalacia patella

Common causes for chondromalacia patella include:

• Acute trauma of the patella, especially fracture or dislocation
• Muscular imbalance in groups around the knee
• Repeated steroid injections in the knee
• Overuse, especially in athletes
• Rheumatoid arthritis
• Osteoarthritis
• Poor alignment of the muscles and bones around the knee

Symptoms of chondromalacia

Symptoms are best characterized as a dull pain around the front of the knee joint, behind the kneecap. This pain is often worsened by going up or down stairs or sitting in one position for an extended amount of time, which often leaves knees feeling stiff.

Chondromalacia can also cause a knee joint to “catch,” meaning it suddenly has difficulty moving past a certain point. It can also cause the knee to give out unexpectedly. These symptoms are more often associated with repeated knee bending in a short period of time.

Depending on the severity of your symptoms, your doctor may examine your knee joint via an arthroscopy. This procedure involves the insertion of small, specialized instruments and a camera – called an arthroscope – through small incisions around the knee. This allows your doctor to be sure that you are suffering from chondromalacia as opposed to another issue that may be treated differently.

Treatments for chondromalacia

Nonsurgical treatments are recommended for most chondromalacia cases. These treatments include:

• Reducing swelling and pain through applying ice after exercise as needed
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen as needed to relieve pain and swelling
• Strengthening the muscles around the knee through creation of an exercise program
• Avoiding motions that put undue stress on the affected area, like high-impact exercises, kneeling, and squatting

When nonsurgical treatments are no longer effective, or if symptoms are severe, an arthroscopic treatment in which affected cartilage is removed, leaving only healthy tissue behind.

At Orthopaedic Associates of St. Augustine, we’re proud to play a role in helping people regain mobility and get back to their lives without pain. If you’re experiencing knee pain, our experienced team of sports medicine physicians is here to help. Please request an appointment online or give us a call at 904-825-0540.

SINA KASRAEIAN, MD 
Board Certified by the American Board of Orthopaedic Surgery and has extensive training in arthroscopy and sports medicine reconstructive procedures.