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"Chondromalacia Patella" in non-technical terms, means "soft kneecap cartilage". While everyone develops chondromalacia of their joints to one degree or another as they age, the articular (joint surface) cartilage that lines the back of the patella seems particularly prone to gradual deterioration and breakdown. The patella is often the first bone in the body to show aging (degenerative) change, beginning in most of us by the age of 35. Clinical evidence indicates that this natural degeneration can be accelerated by genetic factors, obesity, unusually stressful and repetitive use of the patellofemoral joint, and/or structural joint injury. In some individuals, chondromalacia patella can occur as early as the teenage years. Such premature chondromalacia is seen somewhat more frequently in females than in males. While treatment is available for this condition, there is no universally successful remedy.

We never seem to pay attention to our kneecaps until they begin to hurt! Chondromalacia is probably the single most common condition suffered by our kneecaps, sometimes causing pain and sometimes not. "Creaky" kneecaps are generally afflicted with chondromalacia, but medical studies have shown that people with such noisy kneecaps rarely notice anything abnormal about them until they actually become painful.

Congenital (inborn) problems with a person's knees such as patellar malalignment (a natural imbalance of patellar posture) can cause chondromalacia by early adulthood. Malalignment affects patellar movement patterns and causes uneven stress to be placed on the patellar joint surface, perhaps similar to the abnormal pressure and friction that produces the uneven wear seen on automobile tires that are out of alignment. Over time, this may lead to advanced patellofemoral arthritis, occasionally occurring as early as the fourth decade of life. Chronic patellar overloading caused by obesity and/or many years of repetitive knee bending/squatting also seems to be associated with premature patellar cartilage breakdown, even in knees with normal patellar alignment.

Chondromalacia patella (which can be considered an early stage of localized, knee joint arthritis) will sometimes remain clinically silent (cause no symptoms) for many years, whereas in other cases it becomes annoying and obvious early on. Patellar pain, combined with crepitation (a sensation of grinding, catching or creaking as one moves the knee), is typical. Sometimes inflammation causes fluid and swelling to develop in the knee. Activities such as stair climbing, squatting and kneeling often become uncomfortable, and in rare cases, almost impossible.


® 2007. The Knee and Shoulder Centers of New Jersey and Pennsylvania.