What is Chondromalacia patella?

Published January 19th, 2022 by Chris Riley
Fact Checked by
Jacqueline Hensler
Medically Reviewed:
Camille Freking

What is chondromalacia | Causes | Athletes | Symptoms | Treatment | Prevention

Chondromalacia patella, also spelled patellae, is an overuse of your knees that causes knee pain and inflammation of the chondral surface, or cartilage on the back of your kneecap.

You may have heard it referred to as "runner's knee."

It's caused by repeated microtrauma to the chondral surface, which can be from repetitive movements like squatting, running, and jumping.

Chondromalacia patella may affect you if you are active in sports at a high level, but it can also be triggered if you have bad posture or work on your feet all day, as well as those who are elderly.

Find more out about the symptoms and treatments for chondromalacia.

What is chondromalacia?

Chondromalacia patella, also called patellofemoral pain syndrome or CMP, is a chondral injury that affects the anterior portion of your patella, also known as the kneecap.

It occurs when you have high impact, repetitive stress on your patellofemoral joint, or knee, which leads to the softening and eventual chipping off, or erosion, of the back part of your patellar cartilage over time.

Erosion of this smooth cartilage will eventually make movement in the knee painful. This will cause pain and irritation to your chondral tissues and will cause you to have difficulty with activities such as walking, running, or jumping.

The name comes from the ancient Greek words for softening, which is "malakia," and cartilage, which is "chondros."

chondromalacia

What are the causes of chondromalacia patella?

There are many causes of chondromalacia patella, but the most common one is repetitive stress on your knees.

When you have high impact or repetitive activities that put stress on your knees, it can cause damage to your chondral tissues over time and lead to chondromalacia patella.

Other causes of chondromalacia patella include chipped bone fragments from a fractured kneecap, improper biomechanics when you walk or run, which puts more stress on your knees, and an injury to your chondral tissues.

There are cases where chondromalacia in the patella can be caused by knee joint overuse injuries that occur when the knee is bent for a long period of time (musculoskeletal) but this is rare.

Who usually gets CMP?

There are many people who can get chondromalacia patellae, but the most common cases occur in athletes.

Athletes usually develop chondromalacia when they participate in high-impact sports such as basketball or soccer which puts stress on your knees over time.

If you injured your kneecap before you also are more likely to develop it.

Nonathletic chondromalacia patella cases usually occur in people who have jobs that require them to be on their feet for a long period of time or people who are obese.

The older you get the more likely you are to have CMP as your joints age. Women are also more likely to get it compared to men due to the fact that they put more lateral pressure on their patella.

People with flat feet or high arches are also at a higher risk for chondromalacia patella because of the abnormal biomechanics, or improper knee alignment, that can occur with these foot types.

Arthritis sufferers also have a higher chance of having CMP.

What are the symptoms of CMP?

If you have arthritis, you will notice the common symptoms of chondromalacia patella can be very similar to that of osteoarthritis and other types of arthritis.

If you have chondromalacia, you may experience pain in your kneecap after sitting for long periods.

You may also feel a popping sensation in your knee as well as pain when you move, especially after exercise or activity.

You will also feel a grinding sensation in your knee at times as well, and if chondromalacia is severe enough it can cause swelling of the patellar area.

What are chondromalacia grades?

There are different degrees or levels of chondromalacia that are based on the softening and erosion of your chondral tissues used by doctors for your diagnosis of chondromalacia patella.

The evaluation of chondromalacia is based on grades one through four.

Grades one and two are considered mild chondromalacia where you have the softening of the cartilage or even the beginning stages of tissue erosion such as small chipped pieces off your patellar cartilage, which causes pain but does not affect your activities too much.

Grade three is moderate chondromalacia that has a medium amount of erosion to your chondral tissues and will lead to sitting out activities that put stress on the knees.

Grade four chondromalacia patella is severe chondromalacia where there is so much erosion of cartilage that it can cause a large amount of pain, swelling, and even permanent damage to your chondral tissues.

At stage four CMP there is bone exposure and your thigh bone will rub against your kneecap bone in your knee which can cause bone damage.

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How do you treat chondromalacia?

There are several different treatment options for patients with chondromalacia patella.

The most common treatments include anti-inflammatory pain relievers such as ibuprofen which can help temporarily with the pain.

If your CMP progresses you may need physical therapy to strengthen the muscles around your knees, such as your thigh muscles, to help with the pain.

The last resort is surgery if chondral tissue damage is severe enough.

Arthroscopic surgery, which is a surgery where they insert a camera inside you to see the damage, may also be used to see the extent of the damage caused by CMP.

How do you prevent chondromalacia?

There is no definite way to prevent chondromalacia patella, but there are some things that you can do to help reduce your risk of developing it.

First and foremost, make sure to ice your knee after any activity or exercise that puts stress on your knees.

You can also try to maintain a healthy weight because being obese puts more pressure on your knees.

If you have flat feet or high arches, you can try to wear orthotics to help correct the abnormal biomechanics and reduce the stress on your kneecap.

Exercising regularly is also beneficial in preventing chondromalacia patella.

If you run or exercise often, it is recommended to replace your running shoes often enough to maintain proper support.

If chondromalacia is affecting your knee, you should keep a strict physical exercise therapy regimen to maintain muscle balance and prevent the erosion of chondral tissues from degrading and worsening chondromalacia grades.

This would include strengthening your hamstring and quadriceps muscle among others. Kneepads can also be utilized if you work on your knees frequently.

Summary

Chondromalacia patella is a condition that affects the cartilage in your knee. It is caused by abnormal biomechanics, arthritis, or excess pressure on the kneecap which causes cartilage damage behind your kneecap that allows your cartilage to erode.

The symptoms of chondromalacia patella can be very similar to osteoarthritis and include pain after sitting for long periods of time, pain when you move, a popping sensation in your knee, and a grinding sensation.

There are different degrees of chondromalacia patella based on the amount of softening and erosion of your chondral tissues.

The most common treatments include anti-inflammatory medication and physical therapy and in severe cases, surgery may be necessary.

There is no definitive way to prevent chondromalacia patella, but there are some things that you can do to reduce your risk of developing it.

If chondromalacia is affecting your knee, you should keep a strict physical therapy regimen, use knee pads if necessary, and maintain a healthy weight among other things.

If you have any other questions please talk to your doctor or healthcare provider.

References and Sources:

Cleveland Clinic 

Cedars Sinai

NIH.gov