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Chondromalacia patella - Treatment

Alternative Names

Patellofemoral syndrome; Knee pain - chondromalacia

Treatment:

Temporarily resting the knee and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain. Physical therapy, especially quadriceps strengthening and hamstring stretching, may be helpful.

Stretch the muscles on the back (hamstrings) and front (quadriceps) of your upper leg.

Your health care provider can teach you ways to make these muscles tighter. Stronger muscles will help hold your kneecap in the correct position.

If you need to lose weight, find out how.

Changing the way you exercise may help:

  • Avoid running straight down hills; walk down instead.
  • Bicycle or swim, instead of running.
  • Reduce the amount of exercise you do.
  • Run on a smooth, soft surface such as a track, rather than on cement.

Other techniques are:

  • Special shoe inserts and support devices (orthotics) may help people with flat feet.
  • Taping to realign the kneecap may help prevent symptoms.

Make sure your running shoes:

  • Are made well
  • Fit well
  • Have good cushion

If the pain does not improve and there are signs of arthritis developing around the kneecap, surgery may be an option. Surgery may be done using:

  • Arthroscopy (using a camera, which allows a smaller cut)
  • An open approach, with a surgical cut

During the surgery, kneecap cartilage that has been damaged may be removed. Changes may be made to the tendons to help the kneecap move more evenly.

Expectations (prognosis):

Chondromalacia patella usually improves with therapy and use of NSAIDs. For the few people who need it, surgery is successful most of the time.

Complications:

The main complication is failure of treatment to relieve pain.

When surgery is necessary, surgical complications may include:

  • Failure to relieve pain
  • Infection
  • Worsening pain

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of this disorder.

  • Reviewed last on: 6/13/2010
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

May TJ. Persistent anterior knee pain. Am Fam Physician. 2007;76:277-278.

De Carlo M, Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med. 2010;29:81-106.

Steiner T, Parker RD. Patella: subluxation and dislocation. 2. Patellofemoral instability: recurrent dislocation of the patella. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Dree's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 22:sect C.

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