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Q: Chrondomalacia ( Answered 5 out of 5 stars,   0 Comments )
Question  
Subject: Chrondomalacia
Category: Health > Conditions and Diseases
Asked by: brewport-ga
List Price: $10.00
Posted: 23 Apr 2004 17:07 PDT
Expires: 23 May 2004 17:07 PDT
Question ID: 335209
What exactly is chrondomalacia?  What are the causes for this
condition?  What are the treatment options?
Answer  
Subject: Re: Chrondomalacia
Answered By: pinkfreud-ga on 23 Apr 2004 18:14 PDT
Rated:5 out of 5 stars
 
I've gathered some online material that will help you understand
chondromalacia. For reasons of copyright, I've posted only brief
excerpts from webpages; if you'd like more in-depth information, you
may want to click the link below each excerpt, and read the entire
article.

-------------------------
 WHAT IS CHONDROMALACIA?
-------------------------

Chondromalacia, also known as "chondromalacia patellae,"
"patellofemoral syndrome," or "runner's knee," is a condition in which
the cartilage beneath the kneecap becomes softened. The word
"chondromalacia" comes from Greek words for cartilage (chondros) and
soft (malakos). The word is pronounced "KON-dro-mah-LAY-she-ah."
Although the cartilage of joints other than the knee (such as the
elbow or the shoulder) can be affected, the great majority of cases
involve the knee.

"Under the knee cap and covering the ends of the femur (thigh bone)
and tibia (shin bone) is a sort of natural shock absorber made of
cartilage. This shock absorber does not come with a lifetime
guarantee; wear and tear over the years can result in a loss of mass
of the shock absorbing cartilage. Once some of this cartilage has
degenerated, the knee obviously cannot absorb or handle shock from
running, for example, as well as it could before. This condition is
referred to as 'chondromalacia patella.' Technically, chondromalacia
is an overuse injury that causes a dull, aching pain under and around
the knee cap."

Go Ask Alice: What Is Chondromalacia?
http://www.goaskalice.columbia.edu/1112.html

"The key message with chondromalacia is that one must understand that
this is not a disease. It is a word which means 'joint cartilage
softening' and this diagnosis can only be made during surgery when the
cartilage is probed or maybe on MRI where the cartilage may be seen to
be abnormal... A number of conditions of the knee can cause joint
surface softening such as abnormal position or tracking of the patella
or a plica."

Knee Guru: Chondromalacia
http://www.kneeguru.co.uk/html/step_05_patella/step_05_chondromalacia.html

-----------------------------
 WHAT CAUSES CHONDROMALACIA?
-----------------------------

"Chondromalacia patellae occurs in two distinct age-groups: It can
happen in the older age-group (in the 40's and beyond) when the
articular cartilage breaks down as part of the wear-and-tear process
that occurs with the rest of the body. The patella cartilage is one of
the earliest places where cartilage breakdown occurs, and is slowly
progressive, leading to degenerative arthritis (osteoarthritis) in the
knee joint.

It can occur frequently in teenagers (especially girls) when the
articular cartilage 'softens' in response to excessive and uneven
pressure on the cartilage, due to structural changes in the legs with
rapid growth, and muscle imbalance around the knee... In many of these
teenagers, the vastus lateralis and vastus medialis components of the
Quadriceps muscle are not well-balanced. The vastus lateralis tends to
be more powerful than the vastus medialis, thus increasing the
tendency for the patella to track or dislocate laterally. This again
puts undue pressure on the lateral facet. This uneven and excessive
pressure on the lateral facet of the patella leads to cartilage
'softening' and breakdown."

OrthoSeek: Chondromalacia Patellae 
http://www.orthoseek.com/articles/chondromp.html

"Chondromalacia patella occurs in adolescents and young adults, more
frequently in women. The cause is thought to be related to overuse
trauma and/or abnormal forces on the knee. Many affected adolescents
have a mildly abnormal alignment of the patella (knee cap) and femur.
Affected people of all ages have knee pain and a grating or grinding
sensation when they extend their knee. The incidence is 2 out of
10,000 people."

Health Central: Chondromalacia Patellae
http://www.healthcentral.com/mhc/top/000452.cfm

"Several factors contribute to the development of knee pain due to
chondromalacia. Occupations involving repeated kneeling, squat-ting,
and climbing stairs or ladders can lead to knee pain. Malalignment of
the leg bones causes some people to develop this problem. For example,
people who are 'knock kneed,' or have what is called valgus alignment,
have increased stress on the area between the patella (kneecap) and
femur (thigh bone). This abnormal pressure causes a breakdown of the
cartilage and knee pain. People who have loose joints and are
hyperflexible also have abnormal stress on their patella and can
develop these changes. Any injury to the knee that bruises the
cartilage can lead to softening. Even a mild injury can easily
interrupt the blood supply the cartilage receives from the underlying
bone and can lead to death of the cartilage cells. Aging may also play
a part."

Hughston Health Alert: Degenerative Chondromalacia
http://www.hughston.com/hha/a_12_4_2.htm

--------------------------------
 HOW IS CHONDROMALACIA TREATED?
--------------------------------

"The only way to alter knee morphology is by performing surgery, and
sometimes that is required. However, in most cases, exercises with or
without formal physical therapy is all that is needed to correct the
problem... In some cases, if the pain persists, your physician may
prescribe physical therapy...

A non-steroidal anti-inflammatory medication like Motrin is often
prescribed by your physician. This is taken regularly, whether you
feel pain or not. By decreasing the inflammation, the pain is often
reduced. But not only that, there is some evidence to suggest that the
drug actually helps in reforming the articular cartilage.

A knee brace is also often prescribed for patients who want to stay
active in sports. The usual brace prescribed is what is known as a
patella stabilizing brace. It consists of a knee sleeve with a patella
cutout, and a horse-shoe pad based laterally to keep the patella from
tracking laterally...

With conservative treatment, about 85% of patients improve enough that
no further treatment is needed. In about 15% of patients, the pain
stays severe, or becomes worse that surgical treatment is needed...
The form of surgery done is usually an arthroscopic surgery. The
surgery is performed through little keyhole incisions with the help of
an arthroscope."

OrthoSeek: Chondromalacia Patellae 
http://www.orthoseek.com/articles/chondromp.html

"The treatment of chondromalacia remains controversial, but most
individuals can undergo effective treatment by resting the knee and
adhering to a proper physical therapy program. Allowing the
inflammation of chondromalacia to settle is the first step of
treatment... The next step in treatment is a physical therapy program
that should emphasize strengthening and flexibility of the quadriceps
and hamstring muscle groups. Use of nonsteroidal anti-inflammatory
medication is also helpful to minimize the pain associated with
chondromalacia. Treatment with surgery is declining in popularity for
two reasons: good outcomes without surgery, and the small number of
patients who actually benefit from surgical treatment... By looking
into the knee with an arthroscope, the surgeon can assess the damage
done to the cartilage. He or she can also assess the mechanics of the
joint to ascertain if there is an anatomic misalignment that could be
corrected. One common misalignment is due to abnormal tracking of the
patella (tracking is simply the movement of the patella as the knee
moves) caused by too much lateral tension. For this problem, a
procedure known as a lateral release can be performed."

About Orthopedics: Chondromalacia 
http://orthopedics.about.com/cs/patelladisorders/a/chondromalacia.htm

"Many forms of nonoperative treatment exist, and most people's
symptoms improve without surgery. Simply strengthening the muscles of
the thigh can reduce knee pain. Bracing or taping the patella in
conjunction with participating in an exercise program often
successfully relieves pain.4 Treating a malaligned foot with the
proper orthosis can lead to pain relief. Recently, American doctors
have started using new gel medications that are injected into your
knee. These gels make joint fluid thicker, essentially acting as a
lubricant. When combined with an exercise program, these medications
have relieved pain in some patients. Sometimes surgery can effectively
treat chondromalacia."

Hughston Health Alert: Degenerative Chondromalacia
http://www.hughston.com/hha/a_12_4_2.htm

Google search strategy:

Google Web Search: "chondromalacia is"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=%22chondromalacia+is

Google Web Search: "chondromalacia" + "causes"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=chondromalacia+causes

Google Web Search: "chondromalacia" + "treatment"
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=chondromalacia+treatment

I hope this helps. If anything is unclear or incomplete, please
request clarification; I'll be glad to offer further assistance before
you rate my answer.

Best regards,
pinkfreud
brewport-ga rated this answer:5 out of 5 stars

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