Summary about Disease
Chondromalacia patellae, often called "runner's knee," is a condition where the cartilage on the underside of the patella (kneecap) softens and deteriorates. This can lead to pain, stiffness, and a grinding sensation in the knee. It's commonly seen in athletes, especially runners, but can also affect non-athletes due to various factors. The condition ranges in severity from mild discomfort to chronic pain that limits activity.
Symptoms
Aching pain in the front of the knee, especially when:
Walking up or down stairs
Kneeling or squatting
Sitting for long periods with bent knees
After exercise
A grinding or crunching sensation (crepitus) in the knee during movement.
Stiffness in the knee, especially after periods of inactivity.
Pain that worsens with activity.
Occasional swelling in the knee.
Causes
Misalignment of the kneecap: If the kneecap doesn't track properly in the femoral groove, it can cause uneven pressure on the cartilage.
Muscle imbalances: Weak quadriceps muscles, especially the vastus medialis oblique (VMO), can contribute to improper kneecap tracking. Tight hamstrings can also contribute.
Overuse: Repetitive stress on the knee joint, such as from running or jumping, can irritate the cartilage.
Trauma: A direct blow to the kneecap or a dislocation can damage the cartilage.
Flat feet (pes planus): Can alter the biomechanics of the leg, affecting knee alignment.
Arthritis: Underlying arthritic conditions can contribute to cartilage breakdown.
Medicine Used
Pain relievers: Over-the-counter pain medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation. Acetaminophen (Tylenol) can help with pain but doesn't reduce inflammation.
Topical pain relievers: Creams, gels, or patches containing NSAIDs or capsaicin can provide localized pain relief.
Corticosteroid injections: In some cases, a doctor may inject a corticosteroid into the knee joint to reduce inflammation and pain. These are typically used sparingly due to potential side effects.
Hyaluronic acid injections (Viscosupplementation): These injections may help lubricate the joint and reduce pain, especially in cases where arthritis is a contributing factor.
Supplements: Glucosamine and chondroitin supplements are sometimes used, although their effectiveness is debated. Note: Medication management should be done by a qualified professional.
Is Communicable
No, chondromalacia patellae is not a communicable disease. It is not caused by an infection and cannot be spread from person to person.
Precautions
Proper warm-up and cool-down: Before and after exercise, stretch the quadriceps, hamstrings, and calf muscles.
Maintain a healthy weight: Excess weight puts extra stress on the knee joints.
Wear supportive shoes: Choose shoes with good arch support and cushioning.
Use proper form during exercise: Ensure correct technique when running, jumping, or lifting weights. Consider a gait analysis for runners.
Avoid overuse: Gradually increase the intensity and duration of activities to avoid overloading the knee.
Strengthen quadriceps and hip muscles: Focus on exercises that strengthen the muscles around the knee, especially the VMO.
Bracing: A knee brace can provide support and help with patellar tracking.
Address foot problems: Use orthotics if you have flat feet or other foot problems that contribute to knee pain.
How long does an outbreak last?
Chondromalacia patellae is not an "outbreak" situation like an infection. It's a chronic condition. The duration of symptoms varies significantly depending on the severity of the condition, the individual's response to treatment, and their adherence to precautions. Symptoms can last for weeks, months, or even years if left unmanaged. With appropriate treatment and lifestyle modifications, symptoms can be significantly reduced or resolved, but recurrence is possible.
How is it diagnosed?
Physical Examination: A doctor will examine the knee for tenderness, swelling, and crepitus. They will also assess the range of motion and stability of the knee joint.
Medical History: The doctor will ask about the patient's symptoms, activity level, and any previous knee injuries.
Imaging Tests:
X-rays: May be used to rule out other conditions, such as arthritis or bone fractures. X-rays don't show cartilage damage directly.
MRI (Magnetic Resonance Imaging): Provides detailed images of the soft tissues in the knee, including the cartilage, ligaments, and tendons. MRI is the most effective way to visualize cartilage damage and confirm the diagnosis.
Ruling out Other Conditions: The doctor will also consider other possible causes of knee pain, such as meniscus tears, ligament injuries, or arthritis.
Timeline of Symptoms
The timeline of symptoms can vary, but a general progression might look like this:
Early Stages: Mild aching pain in the front of the knee, often after exercise or prolonged sitting. Pain may be intermittent.
Progression: Pain becomes more frequent and intense, occurring during activities like walking up or down stairs, kneeling, or squatting. Stiffness may develop.
Advanced Stages: Chronic pain that limits activity. Crepitus becomes more pronounced. Swelling may occur after exercise. If left untreated, the condition can lead to a reduced range of motion and increased pain with everyday activities. It is important to note that the symptom progression can vary based on individual factors, the level of activity, and the effectiveness of any interventions.
Important Considerations
Early diagnosis and treatment are crucial to prevent the condition from worsening.
Physical therapy is a cornerstone of treatment, focusing on strengthening the quadriceps, hamstrings, and hip muscles, as well as improving flexibility and patellar tracking.
Lifestyle modifications are essential for managing the condition, including avoiding activities that aggravate the pain, maintaining a healthy weight, and wearing supportive shoes.
Surgery is rarely needed and is usually reserved for severe cases where conservative treatment has failed. Surgical options may include arthroscopic procedures to smooth the cartilage or correct patellar alignment.
Compliance with treatment recommendations is important for achieving the best possible outcome.
Individualized approach: Treatment needs to be tailored to each individual based on the severity of the condition, their activity level, and their response to treatment.