Chondropathy of the patella

What is chondropathy of the patella?

Chondropathy of the patella is a condition characterized by softening and deterioration of the cartilage that lines the back of the kneecap (patella). This cartilage is crucial for the smooth movement of the kneecap on the femur, acting as a shock absorber and reducing friction. When this cartilage is damaged, it can cause pain in the front of the knee, especially when going up or down stairs, sitting for long periods of time, or performing activities that involve bending the knee.

What causes chondropathy of the patella?

The exact cause of chondropathy of the patella is unknown, but it is thought to be caused by a combination of factors, including:

1. Biomechanical and Anatomical Factors:

• Patella malalignment: This is one of the most common causes. This can be due to:
• Increased Q angle: A high Q angle (the angle formed by the quadriceps tendon and the patellar tendon) can cause the patella to slide laterally, increasing friction.
• Patella alta or baja: An abnormal position of the patella can alter the way it slides on the femur.
• Trochlear dysplasia: Malformation of the femoral trochlea (the groove in the femur where the patella slides).
• Muscle imbalances: Weakness or atrophy of the quadriceps (especially the vastus medialis), tight hamstrings, or weakness of the glutes can affect the stability and movement of the patella.
• Problems in other joints: Abnormalities in the hip (excessive femoral anteversion) or feet (such as flat feet or valgus feet) can affect knee alignment.

2. Trauma:

• Repeated trauma (microtrauma): Small, repeated blows to the knee, especially in high-impact sports (running, jumping, soccer, basketball, tennis, etc.) or activities that involve deep knee flexion (cycling, CrossFit).
• Direct trauma: Strong blows or falls directly on the kneecap.

3. Overuse and Physical Activity:

• Overtraining: Excessive physical activity without adequate rest.
• Improper technique: Poor technique when running or exercising can increase the stress on the kneecap.
• Insufficient warm-up: Not warming up properly before exercise.
• Wearing inappropriate footwear.
• Sedentary lifestyle: Although it may seem contradictory, a lack of physical activity weakens the muscles, which can overload the kneecap when starting impact sports unprepared.

4. Degenerative Factors:

• Age: Cartilage wear is a natural process that worsens with age.
• Bad habits: A sedentary lifestyle, poor posture at work, and poor diet can contribute to the early onset of degeneration.

5. Diseases and Medical Conditions:

• Arthritis and osteoarthritis: Diseases that affect the joints and can cause cartilage wear.
• Metabolic diseases: Such as diabetes.
• Infections or inflammation: Can affect cartilage.
• Gout: Accumulation of uric acid crystals in the joints.
• Osteochondritis: A condition that affects the bone beneath the cartilage.
• Previous dislocations of the patella.

6. Other Risk Factors:

• Female sex: Women are more prone, possibly due to wider hips that alter the Q angle and often less powerful leg muscles.
• Overweight or obesity: These increase the load on the knee.
• Genetic factors: Some people may have a genetic predisposition due to the structure of their joints.

How is chondropathy of the patella diagnosed?

The diagnosis of chondropathy of the patella is based on clinical and radiological evaluation.

• Clinical evaluation may reveal symptoms such as knee pain, especially in the front, difficulty extending the knee, a feeling of locking or instability, and pain when climbing stairs or running.
• Radiological evaluation may reveal a deformity or alteration in the shape or position of the patella, which may indicate chondropathy of the patella.
• Additionally, techniques such as MRI or arthroscopy may be helpful to confirm the diagnosis and determine the severity of the condition.

How is chondropathy of the patella treated?

Treatment for chondropathy patella depends on the severity of symptoms and the patient's age. Some options include:

• Physical therapy: Stretching and strengthening the knee and leg muscles can help relieve stress on the patella and prevent future injuries.
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
• Ultrasound-guided injections of corticosteroids or platelet-rich plasma can help relieve pain and inflammation, improving joint function.
• Lifestyle changes: Avoiding activities that aggravate symptoms and making changes to the way you walk or run can help prevent future injuries.
• Surgery: In severe cases, surgery may be necessary to repair or replace the damaged patella.

Make an appointment with Dr. Jordi Jiménez. He will see you in the center of Palma and help you regain your quality of life.