Chondromalacia Patella: Causes, Symptoms, Etiology, Risk Factors, Diagnosis
What is Chondromalacia Patella of the Knee?
There is a cartilage present beneath the kneecap that acts as a natural shock absorber for the human knee joint. Chondromalacia patella (CMP) is a condition in which this cartilage gets damaged due to injury, overuse, or any other such factors.
The common symptoms in the condition of chondromalacia patella (CMP) are pain during climbing up or down the stairs. It can be treated simply with the help of ice and rest but, many times it requires a physical therapy or surgery for correction.
In most of the cases, chondromalacia patella is found to be the reason of knee pain, particularly in women.
What is Patellofemoral Pain Syndrome?
It is a term medically applied to define a condition of pain around the kneecap- patella or in the front portion of the knee. Often there are no other signs or symptoms observed along with it. Patellofemoral pain syndrome is also known as patellofemoral syndrome.
What Does the Patella Do?
Patella, most commonly known as knee cap or knee pan, is triangular-circular shaped thick bone that runs along with thigh bone (femur). The role of the bone is to protect and cover the knee joint's anterior articular portion.
What Causes Chondromalacia Patella?
There are no specific causes behind chondromalacia patella, but it usually accompanies:
- Knee Over Usage Can Lead To Chondromalacia Patella. Regular stress on the knee joint that can be sustained during sport activities like jumping or running.
- Lack of Control Over the Thigh Muscles. Chondromalacia patella often occurs in surrounding muscles of the thigh, and knee of an individual do not work properly to maintain tracking of the kneecap.
- Bruise to the Knee Joint. Damage to the kneecap, like a fracture or dislocation is linked with chondromalacia patella.
What is the Etiology of Chondromalacia Patella?
Articular cartilage is responsible for smooth movement of patella and for shock absorption. The cause for damage to articular cartilage can be acute trauma or a chronic overuse injury. Acute trauma occurs when the anterior side of the knee cap is hit directly from an impact like falling directly onto the kneecap. This causes the cartilage to tear up or make the cartilage irregular in shape. In case of overuse of the kneecap, the damage occurs due to recurrent chafing of the cartilage area against the underlying bone.
The patella moves across the knee in a gliding, smooth movement in a healthy individual. In case of patients with chondromalacia patella (CMP), the kneecap rubs against the portion of the joint situated posterior to it. This produces inflammation, degeneration and pain. A common characteristic of chondromalacia patella is the mal-tracking of patella. Chondromalacia patella (CMP) is often caused due to muscle imbalances, where the muscles are very tight or weak. The cause for chondromalacia patella can also be structural problems such as patella alta in which the patella is situated abnormally high or patella baja, where patella is situated abnormally low. Chondromalacia patella (CMP) is more common in athletes. It is more common in females than males as females have on average higher Q angle. People with previous traumatic knee injuries such as fractures and dislocations are also more likely to suffer from chondromalacia patella (CMP). Chondromalacia patella (CMP) can be confused with Patello-femoral Pain Syndrome (PFPS) as PFPS often causes chondromalacia patella (CMP); however, both can also occur individually.
What are the Signs and Symptoms of Chondromalacia Patella (CMP)?
The following are the general signs and symptoms of chondromalacia patella (CMP):
- Chondromalacia patella (CMP) symptoms include a slight discomfort on the inner front part of the knee. It gets intensified by physical activity like running, jumping, climbing up and down the stairs, or sitting with bend knees for a prolonged duration.
- Some may also observe fullness or tightness in the region. If these chronic symptoms are neglected, it may lead to loss of thigh (quadriceps) muscle strength resulting in the leg to collapse.
- A reduction in the muscle mass of the quadriceps, slight swelling in the knee may also be seen.
- One of the symptoms of chondromalacia patella is that straightening the knee produces crepitus.
- Pain felt at the anterior side of the knee. Increasing pain when walking downstairs.
- Pain upon pressure on the knee cap.
- Pain in the knee upon standing after prolonged sitting.
What are the Risk Factors for Chondromalacia Patella (CMP)?
The risk factors that can increase the chances of occurrence of chondromalacia patella (CMP) include:
- The person's age. The affected individuals are mostly adolescents or young adults. In older generation, the knee problems are most likely to be caused due to arthritis.
- Men or women. Women tend to develop chondromalacia patella (CMP) twice as likely as men. The reason behind this can be because women have wider pelvis due to which the angle between the bones at the knee joint increases.
- Involving in specific sports. Active sport players that take part in running or jumping put extra stress on their knees, especially during sudden increase in the intensity of training.
Are there any Complications Involved in Chondromalacia Patella (CMP)?
Chondromalacia patella (CMP) can cause difficulties in performing daily activities like climbing stairs.
What Tests are Conducted to Diagnose Chondromalacia Patella (CMP)?
Doctor conducts physical examination to check chondromalacia patella (CMP) in which he/ she will put pressure on different areas around the knee and make your leg move in different positions. These examinations will confirm the signs of chondromalacia patella (CMP) and rule out the possibilities of other similar conditions.
For further examination, the doctor will recommend following imaging tests for the condition of chondromalacia patella (CMP):
- X-Ray Test: X-ray images of your knee joint will be taken by passing a small quantity of radiation through the body. It will give a perfect visualization of the bone, but is not very effective for examining soft tissues.
- CT (Computerized Tomography) Scan: This technique involves a combination of cross-sectional images of the internal structures taken by various X-rays. They are used to view bones as well as soft tissues. The radiations used are of much higher dose as compared to that in X-ray imaging.
- MRI (Magnetic Resonance Imaging): This technique involves the use of radio waves in strong magnetic field in order to create a detailed image of soft tissues and bones. MRIs are the most expensive out of all other techniques.