Patellofemoral Arthralgia (Chondromalacia Patellae)

What is Patellofemoral Arthralgia (Chondromalacia Patellae)?

Patellofemoral Arthralgia and Patellofemoral Chondromalacia represent two common knee conditions characterised by anterior (frontal) knee pain made worse by activities such as climbing stairs, descending stairs, or prolonged sitting. These conditions are often accompanied by crepitus (a grating sensation or sound within the knee joint), and are typically the result of prolonged repetitive maltracking of the patella, leading to irritation and damage to the anterior structures of the knee.

Patellofemoral Arthralgia, a soft tissue disorder, presents as anterior knee pain resulting from inflammation and irritation of the patellofemoral joint’s soft tissues, including the synovial membrane and surrounding ligaments. On the other hand, Patellofemoral Chondromalacia involves damage to the cartilage on the underside of the patella, leading to degenerative changes and potential loss of cartilage integrity.

Both conditions share similar clinical presentations, with patients experiencing anterior knee pain that worsens during activities involving flexion and extension of the knee joint. Climbing up and down stairs or prolonged periods of sitting exacerbate symptoms, as these movements place increased stress on the patellofemoral joint. Crepitus may also be present, manifesting as a grating sensation or audible noise within the knee joint during movement.

The underlying cause of patella maltracking can vary and may involve multiple contributing factors. An increased Q angle (the angle formed by the thigh bone and the shin bone), is commonly associated with patellar malalignment and instability. underdevelopment of one of the joint surfaces, high riding of the patella and/or a muscular imbalance involving the muscles that attach to the patella. Additionally, anatomical variations such as underdevelopment of one of the joint surfaces or high riding of the patella can predispose individuals to patellofemoral arthralgia and chondromalacia. Furthermore, muscular imbalances involving the quadriceps muscles, particularly the vastus medialis oblique (VMO), vastus lateralis, and vastus intermedius, which attach to the patella, can disrupt patellar tracking and contribute to anterior knee pain.

In summary, patellofemoral arthralgia and chondromalacia are common knee conditions characterised by anterior knee pain exacerbated by activities involving knee flexion and extension. Understanding the underlying causes and implementing targeted interventions are essential for effectively managing these conditions and improving patient outcomes.

Aysin, I.K., Askin, A., Mete, B.D., Guvendi, E., Aysin, M. and Kocyigit, H., 2018. Investigation of the relationship between anterior knee pain and chondromalacia patellae and patellofemoral malalignment. The Eurasian journal of medicine, 50(1), p.28.

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