Managing Chondromalacia: A Comprehensive Guide to Diagnosing and Treating Runner's Knee

Introduction

Chondromalacia, often referred to as "runner's knee," is a condition characterised by the deterioration and softening of the cartilage on the underside of the kneecap (patella). This article aims to elucidate the risk factors and treatment options for chondromalacia, offering patients a comprehensive understanding of this condition.

What is Chondromalacia?

Chondromalacia patellae involves the softening and breakdown of the cartilage beneath the kneecap. This cartilage is vital as a natural shock absorber and ensures smooth movement of the knee joint. Its wear can lead to pain and discomfort, especially when the knee is bent during activities like climbing stairs or squatting.

Risk Factors

Several factors increase the likelihood of developing chondromalacia:

1. Age and Gender: Adolescents and young adults, particularly females, are more susceptible to this condition.
2. Physical Activity: Athletes and those engaged in high-impact sports such as running or jumping face a heightened risk.
3. Knee Trauma: Prior injuries to the kneecap, like fractures or dislocations, can predispose individuals to chondromalacia.
4. Muscle Weakness: Imbalances or weakness in the thigh muscles (quadriceps) can lead to kneecap misalignment and increased stress.
5. Flat Feet: This condition can exacerbate chondromalacia, altering leg alignment and movement.

Symptoms

The primary symptom of chondromalacia is a dull, aching pain at the front of the knee, worsened by sitting for long periods, knee bending, or knee-intensive activities. There may also be a grinding or cracking sensation when extending the knee.

Diagnosis

Diagnosis typically involves a physical examination, with imaging tests like MRI or X-rays recommended to assess cartilage damage severity and exclude other knee issues.

Treatment Options

1. Conservative Treatments:

   • Physical Therapy: Exercises to strengthen and stretch muscles, improving balance and knee alignment.
   • Rest and Activity Modification: Avoiding symptom-aggravating activities and choosing low-impact exercises instead.
   • Pain Management: Over-the-counter pain relievers, such as ibuprofen, can help reduce pain and swelling.

2. Surgical Options: In severe cases, surgery may be recommended, including:

   • Arthroscopy: A minimally invasive procedure to smooth rough cartilage surfaces.
   • Realignment: Surgical realignment of the kneecap may be necessary in cases of misalignment contributing to the condition.

3. Regenerative Medicine:

   • Stem Cell Therapy and Platelet-Rich Plasma (PRP): These emerging treatments involve injections into the knee to promote healing and regeneration of damaged cartilage.

Conclusion

Chondromalacia is a prevalent knee issue, especially among young adults and athletes. Recognising risk factors and seeking early intervention with suitable treatment can significantly enhance outcomes and lessen the risk of long-term complications. Individuals experiencing knee pain should consult a healthcare professional for an accurate diagnosis and a tailored treatment plan.