Chondromalacia patellae – Etiopathogenesis, Clinical features and Management

  • Chondromalacia patellae is a degenerative condition affecting the articular cartilage of patella
  • Unbalanced contraction of the components of quadriceps femoris (weakness of vastus medialis with over action of vastus lateralis) causes the patella to be shifted to one side in the patellar groove
  • This causes compressive and shear forces which cause progressive damage to the articular cartilage

Clinical features:

  • Generalised pain in the knee
  • Pain and stiffness in the knee with prolonged sitting (Theater sign / Movie sign – experienced after sitting at a movie theater for a long time)
  • There is also pain during climbing stairs
  • Swelling in the knee due to effusion with positive patellofemoral grinding test occurs in late stages

Investigations:

  • Radiographs show irregular patellar surface
  • Arthroscopy can help visualise the damaged articular cartilage

Treatment:

  • Application of ice
  • Ultrasound massage
  • Realignment of the patella in the patellar groove by orthotic therapy
  • Arthroscopic shaving of the retropatellar surface

References:
Textbook of Orthopedics, Ebnezar, 4th edition, p426
Sports Medicine Essentials: Core Concepts in Athletic Training and Fitness … By Jim Clover
Fundamentals of sports injury management By Marcia K. Anderson

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