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Anterior knee pain (AKP) and chondromalacia patella: Treatment, symptoms, advice and help

About anterior knee pain (AKP) and chondromalacia patella

Chondromalacia patella is also called ‘runner’s knee’ due to its frequent occurrence in runners and other sport persons. The patella also known as ‘knee cap’ is a protruded, movable bone seen in front of knee. ‘Chondro’ means cartilage and ‘malacia’ stands for softening or weakening; so chondromalacia patella is a painful condition of the knee resulting from the weakening of the cartilage underneath the patella.

Anterior knee pain (AKP) and chondromalacia patella: Incidence, age and sex

Chondromalacia patella is most commonly seen in women. It may be present in any age but usually affects young and middle aged adults. Young athletes both men and women, are also prone to anterior knee pain.

Signs and symptoms of anterior knee pain (AKP) and chondromalacia patella: Diagnosis

An individual with chondromalacia patella complains of vague pain in the knee which may be augmented on certain physical activities like running, squatting and climbing up and down the stairs. Sometimes one may feel a grinding sensation in the knee on straightening of the leg. Stiffness of the knee joint may occur on prolonged sitting. On physical examination, the knee surgeon may note a swelling of the knee or mal-alignment of the patella with the thigh bone called femur. Knee pain may be augmented on gently pressing upon the knee cap. The surgeon may advice imaging tests like X-ray of knee joint either to confirm mal-alignment of patella and femur or to rule out other pathology. Chondromalacia patella itself is a clinical diagnosis and damage to cartilage is not seen on the X-ray.

Causes and prevention of anterior knee pain (AKP) and chondromalacia patella

A number of factors may cause damage to the cartilage underneath the patella, of which wear and tear of the knee joint is the commonest. Other factors include excessive strain on the knee which may be due to increased weight bearing or obesity. Any knee injury like fracture or ligament tear may also pose a risk of chondromalacia patella in the future. Moreover decreased muscle strength, especially of the quadriceps may diminish joint support, which in turn may cause unwarranted strain on the knee joint. At times, this may occur in older individuals due to degeneration of the cartilage, as a result of normal aging processes. Some sports like cycling, soccer, tennis, and ballet dancing may trigger this condition in susceptible individuals.

Anterior knee pain (AKP) and Chondromalacia patella: Complications

Complications of chondromalacia patella are rare except for longstanding and resistant knee pain. Rarely surgical correction of this condition may be complicated with post-operative infection.

Anterior knee pain (AKP) and Chondromalacia patella: Treatment

The goal of treatment is to minimise pain and inflammation of the knee joint. The knee surgeon may prescribe some NSAIDs analgesics which may help in eliminating both pain and inflammation. Cold compress may also help in minimising pain and swelling. The affected individual is advised to give rest to the knee joint. Brace the patella while exercising and avoid strenuous physical exercises. Surgical modality of treatment may be needed in rare cares where mal-alignment of the patella and the femur demands correction.