Patellar Chondropathy: Grades, Symptoms, and Management
The patella (kneecap) sits directly on the femur; between these structures, there is cartilage that prevents friction between both. When Patellar Chondropathy occurs, this cartilage wears down or softens because the patella is slightly displaced toward the outer side, going from smooth to rough, producing friction between the femur and the patella. There are several grades of injury:
- Grade 1: The cartilage has softened.
- Grade 2: The cartilage surface appears altered.
- Grade 3: The deeper layers of the cartilage are altered.
- Grade 4: There is an alteration of the subchondral bone.
When a person presents an increased Genu Valgum (knock-knees), this pathology may occur because the asymmetry causes wear to be greater in a shorter time; if the patella is not correctly aligned, it alters the cartilage, making it thinner and irregular, and in some cases producing tears or fissures. Another cause is excessive use of the knee or an incorrect way of walking, such as that produced by wearing high heels.
Athletes are most prone to this type of condition due to the pressure they subject their knees to. Also, older people who already have pathologies such as arthritis or arthrosis.
Symptoms:
The main symptoms of this condition are crepitus (grinding) in the knee when flexing it and pain in the front part of the knee that worsens after sitting for a long time—because the patella is irritated and inflamed—or when climbing stairs or kneeling. Many patients feel the need to stretch their leg when they have been sitting for a long time because they feel a great pressure on the knee that is relieved by extending it.
What should I do?
When pain appears or if your knees feel constantly tired, the first step is to consult with a specialist doctor to determine the causes of the pain and confirm if it is Patellar Chondropathy, as symptoms also repeat in other pathologies or injuries. It is necessary to perform diagnostic imaging such as an X-ray to know if this is indeed what is happening in the knee.
Management:
If Patellar Chondropathy is detected in its early stages, the most important thing is to make a great effort to slow down the deterioration of the cartilage. This is achieved by applying corrective measures such as physical rehabilitation, with emphasis on strengthening the quadriceps, balance, and movement control, avoiding activities that increase damage to the cartilage such as climbing stairs. Treatment will also be supplemented with anti-inflammatories and analgesics.
Other treatment options are Viscosupplement Injections or Platelet-Rich Plasma; although they are not a cure, they help relieve the symptoms produced by constant friction and, in the case of the former, improve its lubrication.
When the grade of the pathology is much higher, surgical management may be necessary. There is no single surgery that can help improve the situation; depending on each patient and the state of their knee, it is determined if it can be an Osteotomy, microfractures, or even a patellofemoral prosthesis.
