Chondromalacia Patellae: Difference between revisions
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== Physical Therapy Management <br> == | == Physical Therapy Management <br> == | ||
The most common way to treat chondromalacia patellae is by strengthening the quadriceps muscle, because it has a very significant role in the movement of the patella.<ref name="Lee Herrington et al." /> Stretching of the vastus lateralis and strengthening of the vastus medialis is often recommended, but they are difficult to isolate because they have the same innervation and insertion.<ref name="aafp" /> Therefore, it’s easier to strengthen the whole quadriceps.<br> | |||
== Key Research == | == Key Research == | ||
Revision as of 15:20, 28 December 2010
Original Editors - Francky Petit
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Search Strategy[edit | edit source]
Search Engines
- Pubmed
- Web of Knowledge
- http://scholar.google.be/
- Youtube
Key Words
- Chondromalacia
- Patellae
- Therapy
- Orthoses
- Physiotherapy
- Anatomy
- Ice Application
- Chondropathie
- Patellofemoral Pain Syndrome
- Therapy
- Anatomy
- Physiotherapy
- McConnell Tape
- Ice Application
Definition/Description[edit | edit source]
Chondromalacia patellae (CMP) is referred as anterior knee pain due to physical and biomechanical changes[1]. It manifests as’ softening, swelling, fraying, and erosion of the hyaline cartilage overlying the patella and sclerosis of underlying bone[2]’.
Simplified, it means that the posterior surface of the patella is going though softening and degenerative changes[3].
CMP is also known as “Patellofemoral pain syndrome (PFP)”[1][4] and “Runner’s Knee”.[5]
Clinically Relevant Anatomy[edit | edit source]
The quadriceps femoris is devided into four different muscles with the same insertion on the patella: the rectus femoris (RF), the vastus lateralis (VL), the vastus intermedius (VI) and the vastus medialis (VM). The VM has oblique fibres , which is reffered to the vastus medialis obliques (VMO)[6]
Epidemiology /Etiology[edit | edit source]
The etiology of CMP is poorly understood, although most authorities believe that the causes of chondromalacia are injury, generalized constitutional disturbance and patellofemoral contact.[7] Sometimes, a weakness of the VM causes the patella to be pulled too far laterally. The patella will grind onto the condylus lateralis, which causes the degenerative disease.[8]
Characteristics/Clinical Presentation[edit | edit source]
The main symptom of chondromalacia patellae is anterior knee pain.[7] The pain is exacerbated by common daily activities that load the patellofemoral joint, such as running, stair climbing, squatting and kneeling.[1] The pain often causes disability which affects short term participation as daily and physical activities.[9]
PFP also causes a deficit in strength of the quadriceps muscle. Therefore, quadriceps strengthening exercises is often part of the revalidation plan.[1]
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
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Medical Management
[edit | edit source]
Although there is no agreement of the treatment of chondromalacia, there is a general consensus that the best treatment is a non-surgical one.[10]
Physical Therapy Management
[edit | edit source]
The most common way to treat chondromalacia patellae is by strengthening the quadriceps muscle, because it has a very significant role in the movement of the patella.[1] Stretching of the vastus lateralis and strengthening of the vastus medialis is often recommended, but they are difficult to isolate because they have the same innervation and insertion.[8] Therefore, it’s easier to strengthen the whole quadriceps.
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1.4 Lee Herrington and Abdullah Al-Sherhi, A Controlled Trial of Weight-Bearing Versus Non–Weight-Bearing Exercises for Patellofemoral Pain, journal of orthopaedic & sports physical therapy, 2007, 37(4), 155-160
- ↑ Gagliardi et al., Detection and Staging of Chondromalacia Patellae: Relative Efficacies of Conventional MR Imaging, MR Arthrography, and CT Arthrography, ARJ, 1994, 163, 629-636
- ↑ http://www.e-radiography.net/radpath/c/chondromalaciap.htm
- ↑ http://www.ubsportsmed.buffalo.edu/education/patfem.html
- ↑ http://orthopedics.about.com/cs/patelladisorders/a/chondromalacia.htm
- ↑ Florence Peterson Kendall et al., Spieren : tests en functies, Bohn Stafleu van Loghum, Nederland, 469p (383)
- ↑ 7.0 7.1 Iraj Salehi, Shabnam Khazaeli, Parta Hatami, Mahdi Malekpour, Bone density in patients with chondromalacia patella, Springer-Verlag, 2009
- ↑ 8.0 8.1 http://www.aafp.org/afp/991101ap/2012.htm
- ↑ Bill Vicenzino, Natalie Collins, Kay Crossley, Elaine Beller, Ross Darnell and Thomas McPoil, Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: A randomised clinical trial, BioMed Central, 2008
- ↑ R van Linschoten et al., Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial, BMJ, 2009
