Treatment, Surgery, Recovery of Chondromalacia Patella
What is the Treatment for Chondromalacia Patella (CMP)?
Chondromalacia patella (CMP) can be initially treated using simple measures such as providing rest to the knee and avoiding physical activities like climbing stairs that can aggravate the situation.
Medications to Treat Chondromalacia Patella (CMP)
Pain relievers like Acetaminophen (e.g. Tylenol etc.), Ibuprofen (e.g. Advil, Motrin IB etc.) or Naproxen (e.g. Aleve) can be taken for relieving pain in chondromalacia patella (CMP).
Physical Therapies (PT) for Treating Chondromalacia Patella (CMP)
Following physical therapy treatment options may be suggested by the physical therapist (PT) for chondromalacia patella (CMP):
- Rehabilitation exercises can help in reducing the pain caused by chondromalacia patella (CMP). Certain exercises can be done to strengthen the muscles supporting the knee like quadriceps, hamstrings and hip abductors- muscles around the hip.
- Supportive braces for knee joint can reduce the pain caused by chondromalacia patella (CMP). Arch supports or knee braces is recommended to protect the joints and bring improvement in alignment of the kneecap.
- Taping around the painful area can aid in chondromalacia patella (CMP). Consult your physical therapist to understand the procedure of taping the knee. This will ease your pain and improve ability.
- Application of ice on the affected area after exercising can help in chondromalacia patella (CMP).
- Knee-friendly sports can help you recover from chondromalacia patella (CMP). These knee friendly games helps in recovering through simple physical sports that do not affect your knees like swimming and bicycling can be done.
Surgery for Chondromalacia Patella
A surgery can be performed if the non-surgical treatments or conservative treatments do not bring any relief. Consult your doctor about the surgical options that can treat chondromalacia patella (CMP). Given below are some of the surgical options:
Lateral Release and Knee Arthroscopy Surgery for Treating CMP
Arthroscopic knee surgery for chondromalacia patella (CMP) helps in free movement of the knee cap. It involves minimal invasive surgery for the treatment of chondromalacia patella (CMP). General or regional anesthesia may be given. During the surgery, a small cut- about 1 cm is made surgically around the knee. The doctor will then insert an arthroscope to view inside the incision and eliminate any damaged portion of cartilage present with the help of surgical instruments. The procedure is also used to identify any anatomic misalignments that have to be corrected for improving the condition. Sometimes, chondromalacia patella (CMP) is caused due to presence of a tight tissue outside the kneecap that causes misalignment. With the help of the surgery, these tight lateral ligaments are removed resulting in free movement of the kneecap.
Patellar Realignment Surgery for Treating CMP
Patellar realignment surgery for treating chondromalacia patella (CMP) aids in positioning the knee cap. The purpose of this surgery is to re-align and position the kneecap. Two basic types include: Fulkerson osteotomy (a Trillat procedure) and Proximal repair procedure. Proximal repair includes repairing of the soft tissue present near the kneecap and Trillat procedure involves removal of the bone- Tibial tubercle, which is slightly raised from the shin bone and shifted to a new position to realign the kneecap. Surgical instruments are used in this process of shifting.
Treatment Summary for Chondromalacia Patella (CMP)
- Examination of the knee joint for pain and testing its function and range of motion.
- Treatment is similar to Patello-femoral Pain Syndrome (PFPS), as the cause for both the conditions is patella mal-tracking.
- X-rays and MRI confirms the diagnosis.
- NSAIDs such as ibuprofen are initially given for pain relief.
- Physiotherapy is recommended for correcting the cause of chondromalacia patella (CMP).
- If the cause of chondromalacia patella (CMP) is muscle imbalance, then rehabilitation program is recommended.
- Knee may be taped.
- Knee support can also be used.
- If conservative treatment such as NSAIDs and physiotherapy is not beneficial, then surgery via an arthroscopy for removal of the damaged cartilage can be done. Although surgery is rarely required in chondromalacia patella (CMP).
What is the Expected Recovery Period or Healing Time for Chondromalacia Patella (CMP)?
A recommendation of recovery period or healing time for chondromalacia patella (CMP) varies with different patients and is dependent on the kind of surgery done. It is most likely that the patients after the surgery are taken to a recovery room and are covered in bandages, a cold pack and a brace on the knee. All these steps ensure the protection of your knee and help in minimizing pain and swelling. Compression stockings can also be worn on the legs to prevent blood clotting. These are worn typically for couple of weeks after surgery. Most will get relieved after few hours of the surgery, and are advised not to drive or else they can feel groggy or unsteady. Sometimes, pain and swelling can be observed after the surgery; however it reduces within a week. Pain medicines can be taken according to the prescription. The patients may be advised to use crutches or cane for minimizing pain and removing knee pressure for quick healing. The doctor may advise to follow RICE method for a few days for chondromalacia patella (CMP). RICE method involves-
- Ice application for not more than 20 minutes
- Compression- for reducing swelling
- Elevation- raises the knee to reduce swelling and pain.
Make an appointment with your physician after one week or two to see any improvements in the knee. However, if there any side effects seen prior to the appointment then consult your doctor immediately.
These side effects may include a fever- more than 101.5° F, chills, vomiting, nausea, and/or diarrhea, discoloration of the knee, pus-like drainage, foul odor drainage, pain in the calf, difficulty in breathing and/or extreme swelling in the lower leg.
What is the Rehabilitation Procedure for Chondromalacia Patella? (CMP)
Chondromalacia patella (CMP) rehabilitation reduces inflammation and pain, toughen the weak muscles present in the hip and knee, and expand tight muscles and gradual recovery to full fitness. The key part often includes taping of the patella.
Reducing Inflammation and Pain Caused by Chondromalacia Patella (CMP)
Avoid physical activities that can aggravate the injury. Make it a general rule that do not take part in those activities that hurt or worsen your condition. Strictly avoid running, jumping, and cycling.
An ice pack can be applied for a maximum of 15 minutes after every hour and then reduce it to every 2 hours to 3 hours daily. Do not directly place it on skin as it may burn.
Compression can be used along with cold therapy for reducing swelling. A compression bandage should be applied after the cold therapy for only about 10 minutes so that it does not cause any damage to the chondromalacia patella tissues.
Chondromalacia Patella Taping
You can tape your knee cap for instant relief from chondromalacia patella pain. The kneecap pulls the site away from the area causing pain thereby, reducing pain and allowing you to perform muscle strengthening exercises. If the patient observes pain during performing daily activities, then he/ she must keep the area taped all day long until the pain stops completely during normal activities. If the patient experiences pain only during sports related activities or exercises for strengthening muscles, then tape only specific areas. The techniques used for taping in the syndrome of patellofemoral pain are similar to that in chondromalacia patella (CMP).