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Your Knee Pain: Is It Chondromalacia?
What is chondromalacia patellae?
Chondromalacia patellae is damage to the patella cartilage. It is like a ’softening’ or ‘wear and tear’ of the cartilage. The roughening or damage can range from slight to severe.

Signs and symptoms of patellofemoral pain include:
A dull, achy pain in the front of your knee
Increased pain when you walk up or down stairs (the most common symptom)
Pain in your knee when kneeling or squatting
Knee pain after sitting for long periods of time
A grating or grinding sensation when you extend your knee
Knee stiffness
Pain around the knee. The pain is usually located at the front of the knee, around or behind the knee cap. The pain is typically worse when going up or down stairs. It may be brought on by sitting (with the knees bent) for long periods.
A grating or grinding feeling or noise when the knee moves knee (‘crepitus’).
Rarely, some fluid swelling (‘effusion’) of the knee joint.

What is the treatment for chondromalacia?
Avoid strenuous use of the knee – until the pain eases. Symptoms usually improve in time if the knee is not over used.
Painkillers – paracetamol or anti-inflammatory painkillers such as ibuprofen may be advised to ease the pain.
Physiotherapy – improving the strength of the muscles around the knee will ease the stress on the knee. Also, specific exercises may help correct problems with alignment and muscle balance around the knee. For example, you may be taught to do exercises which strengthen the inner side of the quadriceps muscle.
Taping of the patella – is a possible treatment which can reduce pain. This is where adhesive tape is applied over the patella, to alter the alignment or the way the patella moves. Some people find this helpful. Some physiotherapists can offer patellar taping treatment.

Surgery
Surgery is not usually necessary, but may be advised if the above treatments have not helped.

Arthroscopic surgery is the usual operation. A tiny flexible camera is inserted into the knee. The surgeon sees the inside of the knee joint and the cartilage, and may then operate through the camera tube, using very fine instruments. Possible surgical treatments are:

Tight ligaments on the side of the patella may be cut to allow the patella to align better and move more smoothly.
Smoothing or ’shaving’ the cartilage behind the patella.
Rarely, if all other options do not help, the patella can be removed (the knee can still function without it).

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