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Chondromalacia


Presentation

  • Chondromalacia, sometimes a precursor of osteoarthritis, is present in the articular cartilage of the patella of most people by the age of thirty; it causes symptoms in only a few, and it gives rise to osteoarthritis in fewer still.[online.boneandjoint.org.uk]
  • Hyaluronic acid (HA) which is present in our synovial fluid is also found in most body tissues. In a healthy adult, synovial fluid HA has a molecular weight of 4-5 million.[sutterhealth.org]
Inflammation
  • This article is about certain forms of inflammation under the patella. For other uses, see Runner's knee. Chondromalacia patellae (also known as CMP ) is an inflammation of the underside of the patella and softening of the cartilage.[en.wikipedia.org]
  • This creates a vicious cycle, where more destruction and inflammation ensue. 50% idiopathic 20% secondary to maltracking; lateral patellar compression syndrome 15% post traumatic 15% due to unstable patella (recurrent dislocation) Wiberg described 3 types[orthopaedicsone.com]
Physician
  • Athletes are advised to talk to a physician for further medical diagnosis as symptoms may be similar to more serious problems within the knee.[en.wikipedia.org]
  • Enhancing Healthcare Team Outcomes The diagnosis and management of chondromalacia patella is complex and best done with a multidiciplinary team that includes an orthopedic surgeon, emergency department physician, sports physician, nurse practitioner and[ncbi.nlm.nih.gov]
Disability
  • Operation, which has been performed only when there are disabling symptoms, may consist in removing part or the whole of the articular cartilage, or in excision of the patella. The results in forty-six knees are given.[online.boneandjoint.org.uk]
Ankle Pain
  • The history should include an evaluation of previous trauma, co-morbid conditions, unstable joints, foot and ankle pain or dysfunction, and activity.[ncbi.nlm.nih.gov]
Irritability
  • Allowing inflammation to subside while avoiding irritating activities for several weeks is followed by a gradual resumption.[en.wikipedia.org]
Stroke
  • Cross-training activities such as swimming – using strokes other than the breaststroke – can help to maintain general fitness and body composition.[en.wikipedia.org]

Treatment

  • But surgery may be needed if other treatments are not helpful.[winchesterhospital.org]
  • The symptoms, signs and treatment are discussed. Operation, which has been performed only when there are disabling symptoms, may consist in removing part or the whole of the articular cartilage, or in excision of the patella.[online.boneandjoint.org.uk]
  • […] ki HK...Mattila VM 2010 30 Capsulolabral advancement for the treatment of glenoid chondromalacia. ( 20608600 ) Arrigoni P...Harwin SF 2010 31 Ulnohumeral chondral and ligamentous overload: biomechanical correlation for posteromedial chondromalacia of[malacards.org]
  • However, in some individuals the kneecap tends to rub against one side of the knee joint, irritating the cartilage and causing knee pain. [10] Treatment [ edit ] In the absence of cartilage damage, pain at the front of the knee due to overuse can be managed[en.wikipedia.org]
  • […] there is no one specific form of treatment that is universally accepted as a standard of care.[ncbi.nlm.nih.gov]

Prognosis

  • It may progress slowly or quickly but there is no clinical method of assessing the prognosis at an early stage. 2. The earliest change is swelling of the cartilage associated with a decrease in the chondroitin sulphuric acid content of the matrix.[online.boneandjoint.org.uk]

Etiology

  • The process is described and the etiology discussed. 3. The symptoms, signs and treatment are discussed.[online.boneandjoint.org.uk]
  • The varied etiological factors of chondromalacia mandate a thorough history and physical evaluation to correctly diagnose this condition and avoid mismanagement due to misdiagnosis.[ncbi.nlm.nih.gov]

Epidemiology

  • Epidemiology More women than men are affected, and this is attributed to increased Q angles in women. There does not appear to a be a hormonal cause of variation.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Hyaline cartilage is composed of chondrocytes that are dispersed throughout an extracellular matrix. This matrix consists of type 2 collagen, proteoglycans, and water.[ncbi.nlm.nih.gov]

Prevention

  • Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up. Prescription or over-the-counter medications may be advised to reduce pain. Physical Therapy A physical therapist will assess the knee.[winchesterhospital.org]
  • Proper management of physical activity may help prevent worsening of the condition. Athletes are advised to talk to a physician for further medical diagnosis as symptoms may be similar to more serious problems within the knee.[en.wikipedia.org]

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