Chondromalacia
Chondromalacia is a condition characterized by softening and damage of joint cartilage, most commonly at the patella (kneecap). It is often described clinically as “patellofemoral cartilage degeneration” and is associated with knee pain that may worsen with activities such as stairs, squatting, or prolonged sitting.
Typical Anatomy and Mechanism
Chondromalacia involves the articular cartilage surface failing to withstand mechanical stress. Maltracking of the patella, abnormal biomechanics, prior injury, or overuse can increase repetitive loading across the patellofemoral joint.
Common Symptoms
Knee pain is frequently anterior (front of knee) and may be associated with tenderness around the patella. Crepitus, pain with stair climbing, and pain after sitting for long periods are commonly reported.
Risk Factors
Risk factors include patellar maltracking, prior knee injury, female sex, high training volumes or overuse, malalignment, and reduced quadriceps or hip strength that affects patellar tracking.
Diagnosis
Diagnosis is based on clinical assessment plus imaging when needed. Plain radiographs may be normal or show alignment issues. Magnetic resonance imaging can show cartilage defects or related findings but can also show incidental cartilage abnormalities.
Treatment Approaches
Conservative management is first-line and typically includes activity modification, physical therapy focused on quadriceps and hip strengthening, and mechanics-based interventions to improve patellar tracking. Anti-inflammatory medications may be used for symptom control. Surgical or procedural options are considered only for persistent symptoms after adequate rehabilitation.
Prognosis
Symptoms often improve with structured rehabilitation and correction of contributing mechanics. Persistence of pain is more likely when maltracking or biomechanical drivers remain unaddressed.