Can chondromalacia patella heal on its own?

Chondromalacia patella usually doesn’t heal on its own without treatment of some sort. This usually entails activity modification and physical therapy. That being said, in my experience as an orthopedic surgeon in Colorado Springs, Colorado, most with chondromalacia patella get better without surgery.

What causes chondromalacia?

Chondromalacia is caused by the underside of the patellar cartilage moving funny, and causing irritation, inflammation, and pain. This is often caused by muscle imbalances around the knee. At about 30 degrees, the patella starts tracking in the patellofemoral groove part of the femur. Normally this is a very low friction situation, but with chondromalacia of the patella there is some abnormal movement causing discomfort in that particular area. Those with chondromalacia patella will report pain in the front of their knee that is worse with stairs, squatting, kneeling, and sitting for a long time. They may also hear crunching that sounds like Rice Krispies.

How long does it take for chondromalacia patella to heal?

If chondromalacia patella is in the early stages, then it will take on the order of a couple months to heal with regular physical therapy. The term chondromalacia refers to the cartilage underneath the kneecap. In the beginning stages, this cartilage is only softened and not cracked. As chondromalacia patella worsens, the cartilage will start to get cracked and then eventually disappear altogether. If someone is in the later stages of chondromalacia patella, it may never fully go away without a knee replacement.

What is the best treatment for chondromalacia patella?

The best treatment for chondromalacia patella is physical therapy. Physical therapy will get at the root cause of the muscle imbalances that caused you to get chondromalacia patella in the first place. Physical therapy for chondromalacia patella should focus on hamstring stretching, strengthening of the vastus medialis obliquus with short arc closed chain exercises, core strengthening, and stretching of the external rotators of the hip. You should also temporarily modify your activities by avoiding activities that involve squatting. What you don’t want to do is just strengthen all of your quadriceps muscles because that is likely to further imbalance your muscles. Icing and anti inflammatories will also help control the pain associated with chondromalacia patella. Some like to wear a knee brace for chondromalacia patella. I would take caution with wearing a knee brace as sometimes this just acts to compress the patella and causes extra pain without any real benefit. Another treatment modality that can help is a steroid injection into your knee. This can help calm down the inflammation in your knee and work wonderfully with a supervised physical therapy program. If you can’t find the time to do a formal PT program, then I would recommend the exercises shown in this video. If all  else fails, surgery with a knee scope can be used to clean out any loose cartilage edges, and possibly replace some of the lost cartilage with fibrocartilage through use of a technique called microfracture.

I hope I was able to answer some of your questions about if chondromalacia patella can heal on its own. If you would like me to treat your chondromalacia patella, contact us below to make an appointment if you are in the Colorado Springs area. I also am available for virtual consults.

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