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All That You Should Know About Chondromalacia Patellae

Chondromalacia Patellae
Chondromalacia Patellae

Chondromalacia patellae, also known as runner’s knee is a condition causes the deterioration of the undersurface of the patella or the knee joint. As the name suggests, the runner’s knee is common among young athletic individuals although older adults with arthritis of the knee also belong to the chondromalacia risk group.

As the condition is mostly caused by the overuse of the knee joint, taking a few days off from training can make a significant improvement in its symptoms. Improper knee alignment is also reported as a cause of the chondromalacia and in the case, taking rest may not be enough to offer the relief you expect.

Causes Of Chondromalacia Patellae

Your kneecap lies over the front of your knee joint. When you bend your knee, the backside of your kneecap glides over the cartilage of femur/thigh bone. When the tendon and/or ligaments that attach your kneecap to the shinbone and thigh muscle fail to move properly, your kneecap will end up rubbing against the femur. The abnormal rubbing causes the deterioration and softening of the patella, the characteristic of chondromalacia patellae.   

Symptoms Of Chondromalacia Patellae

Chondromalacia patellae manifest themselves in the form of pain in the knee region. The pain is referred to as patellofemoral pain. You can feel the sensation of cracking or grinding as you extend or bend your knee. Getting involved in activities that apply pressure to your knees for long periods of time worsens the condition. Longer hours of exercise or standing for an extended period of time are some examples.

Diagnosis Of Chondromalacia Patellae

To suggest advanced diagnostic methods, your doctor will first look for tender and swollen areas in your knee. They will also check the alignment of your kneecap with the thigh bone. Misalignment if found could be an indication of chondromalacia patellae. In order to get a general idea about the severity of the condition, the doctor may apply resistive pressure to your extended kneecap.

After the initial checkup, they may recommend any of the following diagnostic tests.

  • X-Rays to find out signs of bone damage or misalignment
  • Arthroscopic exam, an invasive procedure that involves inserting an endoscope and camera into the knee joint to see the inside of the knee.
  • Magnetic resonance imaging to find out the wear and tear of the cartilage.

Grading Chondromalacia Patellae

The condition can belong to any of 4 grades according to its severity that is understood by employing appropriate diagnostic methods. The grades are:

Grade 1: The severity indicates that there is softening in the cartilage of the knee.

Grade 2:  This severity grade indicates that there is a softening of the cartilage accompanied by abnormal surface characteristics. Tissue erosion usually begins at this stage.

Grade 3: Active deterioration of the tissue and thinning of the cartilage are the characteristics of this severity grade.

Grade 4: This grade has the highest severity. It indicates exposure of bone with the deterioration of a significant portion of cartilage. Bone exposure means that bone-to-bone rubbing could be occurring in the knee.

Treatment Of Chondromalacia Patellae

All treatment measures aim to reduce the pressure on the kneecap, as well as the joint. The cartilage damage caused by intense physical activity repairs itself if you take enough rest. Here are the treatment methods that are commonly followed.

Physical Therapy

Non-weight bearing exercises like riding a stationary bike or swimming are generally recommended as part of physical therapy. Isometric exercises that involve tightening and releasing your muscles can contribute to maintaining muscle mass.


Surgical operations like the lateral release, implanting a cartilage graft, and smoothing of the back of kneecap are generally used to treat chondromalacia patellae. While performing a lateral release, the surgeon cuts out some of the ligaments in the affected region for better freedom of movement.

Risk Factors Of Chondromalacia Patellae

Some factors that increase the risk of developing chondromalacia patellae include:


People who belong to the younger age group belong to the high-risk group.

Flat Feet

When compared to higher arches, having flat feet puts more pressure on the knees and contributes to a higher risk of developing the condition.


Arthritis in itself is a serious condition that puts you through severe pain cycles. In some cases, the runner’s knee could be an indication of arthritis.

High Activity Level

If you are regularly involved in activities that put a lot of pressure on your knees, the chance of developing knee problems including chondromalacia patellae is more.

Previous Injury

A history of the previous injury to the kneecap like its dislocation can put you at a higher risk of developing chondromalacia patellae.

Making suitable adjustments in your lifestyle can make significant contributions to preventing the condition, as well as reducing its symptoms. If you have to spend a lot of time on your knees, better wear kneepads.