Four years ago, a friend of mine had to accompany his 23-year old daughter, Shiela, to a doctor to have her right knee examined. Shiela was then complaining that her right knee hurts when she sits for a long time. After a thorough examination, the doctor concluded that Shiela was suffering from chondromalacia in her right kneecap. The doctor then prescribed an anti-inflammatory medication and advised her to get as much rest as she can.
A type of knee injury, chondromalacia is specifically an impairment or deterioration of the cartilage lining the underside of the patella (kneecap). Typical of this condition is pain in the front portion of the knee that gets worse during long periods of sitting; others experience severe pain while doing certain tasks as climbing stairs or squatting. The pain experienced in chondromalacia is usually accompanied by a popping or creaking sound when the knee is straightened.
Medical records show that chondromalacia affects young men and women. This type of knee injury may result from any one of the following: overexertion or injury, patellar dislocation, or congenital abnormality in the knee. In some cases though, doctors have difficulty establishing the cause. If injury to the cartilage is severe, chondromalacia may lead to osteoarthritis – an even worse condition.
An injury to the knee often dislodges the kneecap from its proper position in the thighbone. In some people, this patellar dislocation takes place for no apparent reason; this may be explained by the fact that structural patellar problems tend to run in families. In some cases, a dislodged kneecap may simply slip back into its normal position; if it however locks out of its proper setting, the pain and swelling it causes can be severe.
For the initial treatment of chondromalacia, doctors will advise the patient to have enough rest; nonsteroidal anti-inflammatory drugs (NSAIDs) will be prescribed, along with a program of exercises to help make the quadriceps (the greater extensor muscle of the front of the thigh that supports the kneecap) stronger. In some cases, however, this standard therapy may be ineffective on chondromalacia. In such cases, the doctor may recommend either a traditional or arthroscopic surgery to smooth, or shave, the underside of the kneecap.
In extreme cases of this type of knee injury, the doctor may perform tendon surgery to alter pressure on the patella. Note, however, that doctors will not resort to surgical removal of the patella unless all the other treatment options have failed. This is because while such surgery almost invariably cures chondromalacia, it also weakens the knee permanently.
Source: “The Knee: Clinical Applications” by Alfred L. Logan, Lindsay J. Rowe, Logan – 1994, pp. 131-132.