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Knee Pain in Young Adults (Chondromalacia Patella)

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Knee Pain in Young Adults (Chondromalacia Patella)

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Pain that occurs in the knee front is becoming common among young people. Read the article to know more about it.

Medically reviewed by

Dr. K. Shobana

Published At April 6, 2017
Reviewed AtMarch 5, 2024

What Is the Anatomy of the Knee Joint?

The most common location of knee pain in young adults is the front of the knee joint. The problem usually arises from the patella (kneecap bone) and surrounding soft tissue.

The kneecap (patella) is a small bone in front of the lower end of the thigh bone (femur). The backside of the kneecap is lined by smooth tissue called cartilage. This covering helps the patella glide in a groove on the lower end of the thigh bone. The kneecap is held on the top by thigh muscles (quadriceps), and the patellar tendon connects the lower part to the shin bone. The function of the kneecap is to aid knee movement and stabilize the knee joint while walking.

What Is Chondromalacia Patella?

It is nothing but knee pain that occurs due to the softening and breaking down of the cartilage below the kneecap.

What Are the Symptoms of Chondromalacia Patella?

The primary symptom is increasing knee pain:

  • Get a feeling of something breaking or grinding.

  • Discomfort when engaging in activities that put a lot of strain on the knees

  • Discomfort when exercising or standing for long periods.

  • A sore knee may also seem swollen or bloated.

  • When rising from a chair.

  • When going and returning to the stairs.

  • Whether kneeling or bending.

What Causes Chondromalacia Patella?

Many theories suggest softening and micro-injuries of this lining to be the cause of knee pain. It could be due to repetitive microtrauma during falls, vigorous, unaccustomed exercises, etc. The abnormal position of the kneecap over the knee joint with or without weak ligaments may also damage the cartilage lining. As the cartilage lining gets softened and roughened, it may cause pain and crepitus (clicks and sounds) over the kneecap. Obesity makes the condition worse.

Who Shares an Increased Risk of Developing Chondromalacia Patella?

  • Individuals with a history of kneecap fracture, dislocation, or injury.

  • Obese people.

  • Young adults, especially females.

  • People who have the habit of exercising, like those involved in bicycling, playing soccer, running, etc.

How Is Chondromalacia Patella Manifested?

  • Pain in the front of the knee.

  • Pain on climbing up and down the steps or ramps.

  • Sudden 'catch' over the kneecap while getting up from the ground.

  • Dull aching pain after sitting for a long time.

  • Discomfort during squatting (using the Indian toilet) and sitting cross-legged.

  • Occasional clicks and sounds over the kneecap.

  • Swelling (knee swelling/joint swelling).

How Is Chondromalacia Patella Diagnosed?

  • Physical Examination: Orthopedician can diagnose based on the symptoms and examine the knee. Sometimes, there may be slight swelling of the joint. The grating sensation behind the kneecap might give us some idea of the roughness of the patella when people tighten the kneecap muscles.

  • Blood Examination: Blood tests can be a standard procedure and might not help.

  • X-rays: X-rays are not helpful as the problem is with the cartilage lining, which cannot be seen on X-rays.

  • MRI Scan: MRI (magnetic resonance imaging) scans can detect changes in the cartilage but are used as a last resort in unresponsive cases.

  • Arthroscopy: To confirm the diagnosis, it is possible to look inside the knee joint and back of the kneecap with a pencil-shaped camera (arthroscope). But arthroscopy is not done just for diagnosis and is only done if there is any need for surgery.

How Is Chondromalacia Patella Treated?

This condition generally improves over a period with some changes in the lifestyle. However, in some patients, symptoms persist for several years.

The following are the treatment modalities employed in its treatment:

1. Analgesics (Pain Killers):

Simple painkillers like Paracetamol and Tramadol may be sufficient in most cases. Sometimes, anti-inflammatory medications (NSAIDs) may be necessary for a short period of time.

2. Nutritional Supplements:

Nutritional supplements to cartilage lining like Glucosamine, Chondroitin, MSM, and collagen peptides can be taken for 2 to 3 months, relieving the symptoms.

3. Injections:

In some unresponsive cases, intra articular Hyaluronic injections can help. They act by providing lubrication between joint surfaces and help to nourish the cartilage lining of the kneecap.

4. Physiotherapy:

Strengthening the anterior thigh muscles (quadriceps) and muscles around the kneecap (VMO) helps keep the kneecap in the proper position.

5. Surgery:

Surgical management is the last resort in severe or unresponsive patients. It can be performed with an arthroscope (keyhole surgery). The principle is to smooth the rough surface of the back of the kneecap. In some cases where there are significant defects in the cartilage, drilling multiple holes into the bone may help regrow some cartilage. Nowadays, this procedure is combined with stem cell treatment in particular cases.

What Are the Dos and Don'ts I Should Follow With Chondromalacia Patella?

  • Please avoid any movement or position that makes people feel pain.

  • It is better to avoid kneeling, squatting, or sitting cross-legged.

  • One may occasionally go up and down the steps but avoid repeated stair climbing.

  • Pain may worsen with exercise, bicycling, and walking on a treadmill with an upward gradient (slope).

  • Maintain ideal body weight; try reducing it if an individual is overweight.

  • Do stretching and strengthening exercises that involve the hamstring and quadriceps muscles.

  • Try to use supporting devices and special shoe inserts to ease the pain.

  • If the way people do regular exercise is the cause of the pain, change the way they do it.

  • While involved in sporting activities, wear shoes that do not cause pain.

What Is the Prognosis of Chondromalacia Patella?

The prognosis in these cases is usually good. The severity of symptoms may vary from time to time, and the patient may have good and bad days. There are no severe side effects of any nutritional supplements; one can use them without hesitation. Maintaining an ideal body weight with exercises to strengthen the knee muscles is crucial to recovery.

Can We Prevent Chondromalacia Patella?

Strengthening the muscles of the quadriceps helps gain the muscle portion that makes tracking the kneecap easy and, hence, helps prevent chondromalacia patella in the long run. Regarding knee pain associated with chondromalacia patella, only the aggravation of symptoms can be prevented by avoiding activities that accentuate the knee pain.

Conclusion:

Chondromalacia patella has become an increasing problem among young adults with a sedentary lifestyle. Therefore, try to maintain the ideal body weight and do regular exercises. While doing workouts, choose the correct form of exercise that fits the individual. If people have been diagnosed with chondromalacia patella, do not worry because it has a good prognosis.

Frequently Asked Questions

1.

What Are the Causes of Chondromalacia?

The causes for chondromalacia are:
- Sprains and strains.
- Injuries.
- Infection.
- Overuse.

2.

What Are the Symptoms of Chondromalacia?

The common symptom of chondromalacia is pain around the patella. This pain can radiate to the inner part of the knee cap. Some patients also experience sharp pain in the surrounding areas of the patella.

3.

Can Chondromalacia Patella Be Cured?

Yes, it is possible to cure chondromalacia. It is not a life-threatening condition. Initially, rest is recommended for the patients. Physical therapy can relieve the symptoms of the individual. Reducing the inflammation caused by chondromalacia can pave the way for the treatment.

4.

How Long Does It Take for Chondromalacia Patella to Heal?

If the patient undergoes physical treatment, then they can heal within four to six weeks. Some patients might take up to one or two months also. A non-surgical method is the most recommended treatment option for this condition.

5.

Is Chondromalacia the Same as Osteoarthritis?

Chondromalacia patella is a condition in which there are alterations in the region of the patella. If chondromalacia is not treated well, then it can result in a condition called osteoarthritis, where the knee joints are affected.

6.

What Exercises Can I Do With Chondromalacia Patella?

The exercises that are recommended for chondromalacia patella are:
- Straight leg lift.
- Wall slide.
- External hip rotation.
- Dumbbell deadlift.
- Quadricep contraction.

7.

Can I Exercise With Chondromalacia Patella?

Yes, you can exercise with chondromalacia patella. Exercising can help you relieve the stress in the involved site. Exercises can help in providing support to the muscles so that the overall symptoms in the knees due to chondromalacia patella can be improved.

8.

What Are the Risk Factors for Chondromalacia?

The risk factors for chondromalacia are:
- Female gender.
- Flat foot.
- Aged people.
- Arthritis.
- Dislocation.
- Increased level of activity.

9.

Why Do I Hear Sounds in My Knees?

In chondromalacia patella, a crackling sound will be heard due to the accumulation of fluid in the joints. It is referred to as water on the knees. This sound can be heard whenever there is irritation in the joints.

10.

How Serious Is Chondromalacia?

Chondromalacia is not a very serious problem but the damages caused by chondromalacia can cause permanent damage. During the initial stages, the doctor tries to perform treatment with the help of non-surgical treatment options. If they are unsuccessful, then the irreparable damage can be treated by surgical procedures.

11.

Does Physical Therapy Help Chondromalacia Patella?

Yes, physical therapy is very useful for treating the condition of chondromalacia patella. The symptoms can be relieved with the help of this condition. Physical therapy is the most conservative method for treating patients. You should consult your doctor and ask for tips in preventing and handling chondromalacia patella.

12.

Does MRI Show Chondromalacia?

MRI can indicate the cracking of the cartilage that could be seen on the undersurface of the patella. If the condition of chondromalacia is in a more severe stage, then it can be easily visualized in an MRI.

13.

How Is Chondromalacia Patella Diagnosed?

The diagnosis of chondromalacia requires a physical examination by the doctor. X-ray of the joints might be necessary to see the damage in the joints. The arthroscopic examination will be helpful to detect the internal structures of the joints. In some cases, MRI might also be necessary to see the wear and tear of the cartilage.

14.

What Is the Best Treatment for Chondromalacia Patella?

The patient should avoid using the stairs for a while. They can also choose to go for ice and heat therapy. Braces are available that can stabilize the knee joints. In addition to this, they can also go for strengthening the joints with the help of exercises.

15.

What Are the Tips to Prevent Chondromalacia?

The following tips can help in preventing chondromalacia.
- Avoid stress while playing sports. Choose to wear a knee cap always.
- It is necessary to strengthen the quadriceps muscles along with the hamstring.
- If you have flat feet, wear suitable shoes.
Dr. Althuri Mohan Krishna
Dr. Althuri Mohan Krishna

Orthopedician and Traumatology

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knee swelling
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