The patella, or kneecap, is a small, triangular bone located at the front of the knee joint. Its underside is covered with smooth articular cartilage that helps the kneecap glide within a groove in the femur as the knee bends and straightens.
Chondromalacia patella—often referred to as “runner’s knee”—occurs when the cartilage beneath the kneecap softens or becomes damaged. This condition can cause pain, grinding, and difficulty with activities such as running, squatting, climbing stairs, or sitting for long periods.
Dr. Brian Cohen is a board-certified orthopedic surgeon with more than 20 years of experience, over 30,000 orthopedic surgical procedures performed, and more than 100,000 patient evaluations. He provides personalized nonsurgical and surgical treatment based on the cause and severity of each patient’s knee pain.
Chondromalacia Patella Causes
Chondromalacia patella is the softening or deterioration of the articular cartilage on the underside of the kneecap. The term “chondro” refers to cartilage, while “malacia” means abnormal softening of tissue.
Possible contributing factors include:
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Repetitive knee activity, including running, jumping, skiing, biking, or frequent squatting
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Weakness or imbalance in the muscles surrounding the knee and hip
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A direct blow or other trauma to the kneecap
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Abnormal kneecap tracking or alignment
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Flat feet or other lower-extremity alignment problems
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Previous kneecap instability or dislocation
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Excess stress across the patellofemoral joint
Runner’s Knee Symptoms
Pain at the front of the knee or behind the kneecap is the most common symptom of chondromalacia patella. Symptoms may become more noticeable when activities increase pressure between the kneecap and the femur.
Other symptoms may include:
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Grinding, clicking, or popping with knee movement
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Swelling or inflammation
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Pain after sitting with the knee bent for an extended period
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Pain during or after running, jumping, or squatting
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Discomfort while walking
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Pain when climbing or descending stairs
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Tenderness around the kneecap
Knee pain that persists, worsens, or begins to interfere with normal activities should be evaluated to determine its underlying cause.
Diagnosing Runner’s Knee
Diagnosis begins with a review of the patient’s symptoms, activity history, previous injuries, and factors that make the pain better or worse. Dr. Cohen or one of his sports medicine colleagues will examine the knee for tenderness, swelling, kneecap tracking, stability, range of motion, and muscle strength.
X-rays may be ordered to evaluate bone alignment, arthritis, or other possible causes of knee pain. Although cartilage damage is not directly visible on a standard X-ray, an MRI may provide additional information about the cartilage beneath the kneecap and other soft tissues.
In selected cases, Dr. Cohen may evaluate the cartilage during knee arthroscopy when surgery is already being considered for persistent symptoms or associated knee damage.
Chondromalacia Patella Treatment Options
Treatment depends on the severity of the cartilage damage, the cause of the abnormal pressure beneath the kneecap, the patient’s symptoms, and the effect on daily activities. Most patients begin with nonsurgical treatment.
Nonsurgical Treatment
Chondromalacia patella can often be managed without surgery. Treatment may include:
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Rest or temporary activity modification
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Ice
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Compression and elevation
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Anti-inflammatory or pain-relieving medication
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A supportive knee brace when appropriate
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Physical therapy
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Shoe inserts or orthotics
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Gradual return to exercise
Physical therapy may focus on strengthening the quadriceps, hips, and surrounding muscles, improving flexibility, and correcting movement patterns that place excessive pressure on the kneecap.
Surgical Treatment
Surgery may be considered when symptoms continue despite appropriate nonsurgical treatment or when there is significant cartilage damage, abnormal kneecap tracking, instability, or associated arthritis.
The recommended procedure depends on the specific condition of the knee and may include:
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Arthroscopic removal or smoothing of unstable cartilage
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Cartilage restoration or transplantation for selected cartilage defects
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A realignment procedure when abnormal kneecap tracking contributes to the damage
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Treatment of associated kneecap instability
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Patellofemoral or total knee replacement in selected patients with advanced arthritis
Dr. Cohen determines the appropriate procedure based on cartilage health, knee alignment, associated injuries, age, activity level, and treatment goals.
Why Choose Dr. Cohen?
OVER 25+ YEARS OF EXPERIENCE
One of the first orthopedic surgeons employed by a large hospital. Dr. Cohen spent 20 years.
TRUSTED BY OVER 100,000+ PATIENTS WORLDWIDE
Over his distinguished career, Dr. Cohen has cultivated a reputation of excellence and trust among his patients and his peers.
UTILIZING THE LATEST TECHNOLOGY
To achieve the best surgical outcomes, Dr. Cohen uses the most advanced technologies and techniques, keeping his practice state-of-the-art.
PATIENT SAFETY IS TOP PRIORITY
An individualized, patient-focused process coupled with decades of training and experience helps ensure maximum safety for all of Dr. Cohen’s patients.
Chondromalacia Patella Care in Chillicothe, OH
Chondromalacia patella can make exercise, stairs, squatting, and everyday movement uncomfortable. Dr. Cohen evaluates kneecap alignment, cartilage health, muscle strength, and activity demands before recommending treatment. Many patients improve with activity modification and physical therapy, while surgery may be considered for persistent symptoms or significant cartilage damage. To schedule a consultation with Dr. Brian Cohen, call (614) 788-0375.