I would appreciate any advice...am 29 year old athletic female, had knee pain that got progressively worse (now am hobbling around) and was diagnosed with patellar tendonitis. After a month of it not going away and severe pain, had an MRI that showed Grade IV chondromalacia. The doctor told me that surgery is not an option and just to take pain meds and go to physical therapy. I can't believe that's my only option at this point - does anyone have experience with this and should I get a second opinion?
How are you? Chondromalacia patella is a common cause of kneecap pain or anterior knee pain. Often called "Runner's Knee," this condition often affects young, otherwise healthy athletes. Chondromalacia is due to an irritation of the undersurface of the kneecap. In some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.
Allowing the inflammation of chondromalacia to settle is the first step of treatment. Avoiding painful activities that irritate the knee for several weeks, followed by a gradual return to activity is important. In this time, cross-training activities, such as swimming, can allow an athlete to maintain their fitness while resting the knee. The next step in treatment is a physical therapy program that should emphasize strengthening and flexibility of the quadriceps and hamstring muscle groups. Majority patient’s recover without surgery.
In case conservative treatment fails, then procedures like lateral release can be performed. Also there is need for activity modification after surgery. Discuss with your doctor regarding the above mentioned options.
Thank you so much Dr Veena! Can I ask you - is it possible to return (eventually, with lots of physical therapy) to running? I have heard mixed things but was wondering if it is at least a possibility. Thanks again!
Thanks for keeping me posted. The primary goal for treatment and rehabilitation of chondromalacia patella is to create a straighter pathway for the patella to follow during quadriceps contraction. Selective strengthening of the inner portion of the quadriceps muscle will help normalize the tracking of the patella.
Cardiovascular conditioning can be maintained by stationary bicycling, pool running, or swimming (flutter kick). Reviewing any changes in training prior to chondromalacia patella pain, as well as examining running shoes for proper biomechanical fit are critical to avoid repeating the painful cycle. Generally, full squat exercises with weights are avoided. Occasionally, bracing with patellar centering devices are required.
Under optimal circumstances, the patient should have a rapid recovery and return at full functional level.
Hope this helps.
my doctor told me that my cartilage under my knee is damaged serverly. I was in a car accident where my knee hit the dash board. (60MPH impact). Is there any surgery for this repair? He suggested physical therapy. Ive read that physical therapy in alot of cases doesnt work. I live in NY Long Island. Does anyone know any specialist. My Op Report states "The superior pole of the patella did have a flap tear of cartilage"The patellofemoral joint and noted that the patient had a significant amount of chondromalacia on the superior aspect of the patella and also a flap tear of the cartilage. I would op for surgery. Please help
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