"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.
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