Stephen J. Schueler, M.D.

Overview Symptoms Evaluation Treatment drugs exercises questions for doctor specialist Home Care pain and inflammation using a cane using crutches warning signs Underlying Cause Anatomy

Patellofemoral Pain Syndrome Treatment

Treatment for chondromalacia usually includes rest, elevation, cold compresses, and nonsteroidal anti-inflammatory medications. Physical therapy helps to strengthen the muscles around the knee to relieve stress on the joint. Shoe inserts and supportive knee braces may improve the alignment of the kneecap over the knee joint. Most cases improve within 6 weeks, but therapy may be required for months.

Those who do not respond to medications and physical therapy may require surgery. During arthroscopic surgery, a thin, flexible scope is used to view the inside of the knee joint. Small pieces of broken cartilage can be removed through small incisions. In severe cases, additional surgery may be required to realign the knee.

Treatment for chondromalacia may include:

Patellofemoral Pain Syndrome Drugs

Drug treatment usually starts with acetaminophen, which is adequate for many people. Acetaminophen suppresses the body's production of the chemicals that cause pain, but does not reduce inflammation. Most people with moderate pain eventually require a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen or naproxen. NSAIDS reduce pain and swelling by blocking the body's production of chemicals that cause pain and inflammation.

Hyaluronan Injections
This treatment is approved for osteoarthritis but may provide temporary relief for those with pain in the knee joints from chondromalacia as well. Hyaluronic acid is a natural component of joint fluid. It acts as a lubricant and shock absorber inside the joints. Inflammation causes the acid to break down, decreasing its effectiveness. Hyaluronan (e.g. Hyalgan and Synvisc) is a synthetic version of the substance that can be administered directly into the joint, usually a series of three shots given over one week.

Hyaluronan not a permanent solution, but pain relief can last for months. It is especially helpful for people who can't take steady high doses of nonsteroidal anti-inflammatory agents or those who fail to respond to other medications.

Patellofemoral Pain Syndrome Exercises

Straight leg lifts can help strengthen the quadriceps muscles and improve chondromalacia of the knee. This can be performed with or without 2-5 lb. ankle weights.

Another useful exercise can be performed by placing a towel between the knees and squeezing the knees together for several seconds. This will build up the medial (inner) aspect of the quadriceps muscle and restore a more normal relationship between the patella (kneecap) and the knee joint.

These exercises, when repeated daily, can dramatically lessen the symptoms of chondromalacia patella. Avoiding stair and hill climbing will also decrease the progression of knee damage.

Patellofemoral Pain Syndrome Questions For Doctor

The following are some important questions to ask before and after the treatment of chondromalacia.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • Will I need physical therapy?
  • What else can I do to reduce my risk for complications?
  • What else can I do to reduce my risk for having this problem again?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Patellofemoral Pain Syndrome Specialist

Physicians from the following specialties evaluate and treat chondromalacia:

Continue to Patellofemoral Pain Syndrome Home Care

Last Updated: May 31, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Patellofemoral Pain Syndrome References
  1. Bosch JJ. Chondromalacia patella. J Pediatr Health Care. 1999 May-Jun;13(3 Pt 1):144. [10531909]
  2. Fredericson M, Yoon K. Physical examination and patellofemoral pain syndrome. Am J Phys Med Rehabil. 2006 Mar;85(3):234-43. [16505640]
  3. Holmes SW Jr, Clancy WG Jr. Clinical classification of patellofemoral pain and dysfunction. J Orthop Sports Phys Ther. 1998 Nov;28(5):299-306. [9809278]
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