Anyone ever heard of Chondromalacia(knee cond.)

[weekendtoy]

My left kneecap is poping and grinding pretty bad when walking up and down stairs.The right knee is not far behind with noise starting.I saw a knee doc and he said it was Chondromalacia.I started Physical therapy but was wondering if anyone else has this or knows anyone with it?

 

[Jaybird]

Dunno what it's called, but my kness sound like a rocking chair contest inside a Texas Roadhouse restaurant. (peanut shells all over the floor):eek:
My wife calls it...old. :(

 

[lawman]

i'm no doc, i don't even play 1 on tv, but i've dealt with this some in my own old knees. it's more commonly called "runner's knee". i'll spare everyone my ignorance of anatomy, & won't explain what i think it involves. it can lead to serious probs if not treated, so you are doing the right thing.

 

[nephron]

Patellofemoral syndrome is one in the same as "Chondromalacia Patella". Chrondromalacia itself, is a different diagnosis and refers to softening (malacia) of the chrondral surfaces or cartilage.

Chondromalacia Patella is a recurrent injury to the subpatellar surface leading to chondromalacia of the subpatellar cartilage, causing knee pain at the "knee cap". The injury's set up by repetitive force trauma (running) in the setting of genu varum (uh, too hard to explain, but basically a bending of the knee, looking front to back, medially toward the crotch :eek: ), excess foot pronation (ankle of angle during foot weighting), femoral anteversion (forget it), and tibial torsion (axial torque applied during max load). Typically affected by patellar instability/laxity, excess tightness of the lateral retinaculum, & weakness of the vastus medialis--all of which can be taken care of with a good bout of physical therapy.

The bottom line? Runner's knee.
Treatment?: Self limited, months to years, but responds very well to correction of the above stated risk factors via PHYSICAL THERAPY. Most people have a hard time "complying" with the exercise regime, and it just gets worse. :(

But, if you really want to know what it is, an Orthopedist is a better source of info. Why aren't there any here? Oh yeah, they're bone doctors, and you know what, you can actually break your bones riding a motorcycle. :confused: So you're not gonna see one here.
Llllooooooossserrrrrsssss!! :p

I'm a Nephrologist, damnit, why can't somebody ask me about glomerulonephritis or dialysis? I guess there's a chance you could lose both kidneys in a major PW50 endo....hmmm.....:think

 

[fastwes]

pain in knees

I had/have the beginning of the same kneecap problem. My doctor gave(sold !!) me a prescription for vioxx. Best damn drug on the planet! I am a new person now (except have all the same personality problems) with no knee, leg, or joint pain.That is one good invention.
Wes Gilbert
Boyesen Precision Porting

 

[nephron]

Yeah, Vioxx and Celebrex are the COX-2 inhibitors. Traditional NSAIDS (nonsteroidal antiinflammatory drugs) such as aspirin, ibuprofen, naproxyn sodium, piroxicam, etc. block both COX-1 & COX-2. (COX is not a pseudonym for male genetalia ;) but stands for cyclooxygenase, the main pathway mediating inflammation).

When COX-2 inhibitors came out, they promised stomach "safety", because traditional NSAIDS block prostaglandin production in the GI tract, resulting in increased risk of gastrointestinal hemorrhage, ulcers, gastritis, etc. However, analysis of level 4 testing these days shows they cause damn near as much NSAID associated antral ulcers as traditional NSAIDS.

There's a whole lot more to this story, but I won't bore you with it. Suffice it to say that I had to reprimand Drug Reps :( and contact the companies themselves because I was seeiing a lot of Acute Renal Failure and Salt Retention. They are currently being overused, and there's been a transition bias of complications accreduted ti COX-2 inhibitors.

The good news is that A) complications are rare, particularly in young folks with normal renal function and B) By specifically blocking COX-2, I believe they work better than traditional NSAIDS. At least that's been my experience thus far.

Bottom line: Vioxx/Celebrex are great drugs for the right people, and work particularly well for musculoskeletal pain and headaches.

Problem is--when your doc runs out of samples, you'll really enjoy paying about 4 bucks a pill, as a script runs 120 bucks a month. :scream: :silly:

Jack

 

[Jaybird]

<-----Proponent of Vioxx ! No belly burn, and even longer lasting (IMO) than Aleve.

Samples still rolling in......hope it continues.

 

[FasterNU]

Chondromalacia patellae and patellofemoral syndrome are not one and the same! Chondromalacia patellae is a specific pathological entity in which there is a softening or fibrillation(fraying) of the patellar cartilage. Most people with patellofemoral syndrome do not actually have Chondromalacia!! Also, a patient with genu valgum is knock kneed, and genu varum is bow legged...I believe Nephron has it backwards. It is my understanding that chondromalacia most often occurs due to chronic overuse and is likely exascerbated by poor mechanics, but in my recollection, is just as frequently associated with a direct blow to the knee.

The treatment usually entails low impact excercises that focus on strengthening the inner part of the quadriceps(vastus medialis), without injuring joints. Main thing is to prevent excess tension on the articular surface of the patella.

 

[Jaybird]

For genu varum....stop riding those damn horses!
For genu valgum....go on a diet!

BTW....my mechanic is very poor, but I don't recall one time he exascerbated anything but my swift payment. Not once did he mention my knees, although he did mention something about his foot and my posterior! :eek:

 

[MX265]

I have never used this, but I know there are some HUGE fans of Vicodin on this forum. I think there was an entire post pertaining to it. From what I was reading in the post replies, when in doubt, take Vicodin. Crunching? You won't feel a thing, won't hear a thing, and probably won't care about a thing. Miracle drug (next to the little blue pill).

Brand name: Vicodin
Pronounced: VY-koe-din
Generic ingredients: Hydrocodone bitartrate, Acetaminophen
Other brand names: Anexsia, Co-Gesic, Hydrocet, Lorcet, Lortab, Zydone

This was taken from website listed below:

http://www.healthsquare.com/pdrfg/pd/monos/vicodin.htm

 

[ET]

The only thing that I have heard of that can repair cartilage is Glucosamine. All the athletes and people with arthritis use it and so far there don't seem to be any harmful side effects.
It would be good to get 3 different brands of it since there are minor variations of it and most brands recommend 3 pills a day.

 

[Jaybird]

You have a point there, ET. There is a jockey, I think it's Shane Sellers, who had career destroying damage to his knees. He was going to retire from riding all together. His therapist put him on a glucosamine program and, according to them, it actually started to restrucure his knee materials. He rode in the Kentucky Derby this year, and swears by the stuff.

 

[nephron]

Great, another one that thinks they know more medicine than a Doc.:silly:

Chondromalacia patellae and patellofemoral syndrome are not one and the same! Chondromalacia patellae is a specific pathological entity in which there is a softening or fibrillation(fraying) of the patellar cartilage. Most people with patellofemoral syndrome do not actually have Chondromalacia!! Also, a patient with genu valgum is knock kneed, and genu varum is bow legged...I believe Nephron has it backwards. It is my understanding that chondromalacia most often occurs due to chronic overuse and is likely exascerbated by poor mechanics, but in my recollection, is just as frequently associated with a direct blow to the knee.

All "symptomatic" cases of chondromalacia patella result in the loose term "patellofemoral syndrome". Of course, all PF is not chondromalacia, but that's not what I said. "One in the same" means, just as above, all symptomatic cases of Chondromalacia Patella ARE, by virtue of their presenting symptoms, Patellofemoral syndrome.

And yes, I wasn't stuttering: genu valgum IS the knee posturing abnormality that predisposes/exacerbates CP/PFS because of the resulting mal-alignment of the subpatellar surface over the lateral femoral condyle. This so-called "knock-kneed" position is particularly common in women, having to do with the effects of Estrogen-induced "softening" of the knee ligaments and tendons (medial/lateral collateral ligaments, iliotibial tract, sartorius and gracilis tendons, and semitendinosis insertion).

Having had said that, I am not a primary care physician and don't do much ortho. But beyond Internal Medicine and its specialties, everything else pales in comparison (in terms of "difficulty").

Keep it coming, I've got an endless supply of whence that came....:)

 

[Jaybird]

"Expert?...No, but I did stay at a Holiday Inn Express last night!"

:confused:

<making note:> ( never exacerbate an orthopedic infarction wif neph....)
<goal for week:> ( use the phrase "semitendinosis insertion" at least once.)

 

[J_dem_Bones]

I had the same problem, untill I had a piece of cartliage break off and got lodged under me knee cap. I had artho-scopic surgery. The doctor said the back side of my knee was so ruff( years of crashing and racing BMX which is a strain to the knees, another story). So he smoothed out all the ruff areas and removed 4 chips out. Now it's like new!!:p
It is like night and day. No more more icing my knee when I'm done riding or working out. But I can use it to my right knee.:eek:
I'm currently taking glucosamine and it seems to help.

But like fastNU said" The treatment usually entails low impact excercises that focus on strengthening the inner part of the quadriceps(vastus medialis), without injuring joints. Main thing is to prevent excess tension on the articular surface of the patella." is the best way to prevent it!! It made both my knees feel much better!!

 

[weekendtoy]

All I know is when I bend down you hear crunching and again on the way up.I started Phys. therp. and when the Phys. therepist heard it she said ahhh my god that sounds horrible.Im shocked you do not feel pain.I'm thinking she was gonna say awe thats nothing I see people like this all the time you have nothing to worry about.She has me working on building muscle in the thighs.

 

[FasterNU]

Great, another braggadocios doctor that thinks he's omniscient...just what the world needs.
Read your own post Nephron Boy, it says genu varum, not valgum. Now, you can cut-n-paste straight off the i-net, misinform, misspell key anatomical terms, and misquote Old English til you're blue in the face. It does not make you an expert in this issue. The fact remains that no Nephrologist (or any doctor for that matter) is more qualified to assess injury and rehabilitate than an Athletic Trainer (which I am) or a Physical Therapist. If you were qualified to perform a Systematic Differential Evaluation Procedure (SDEP) you would know that patellofemoral syndrome and "symptomatic" chondromalacia patellae are not one and the same. They have different asterisk signs/symptoms and each disorder has it's own Special Tests. There's nothing more irritating than a misinformed doctor with an ego the size of Texas...especially when he's leading others astray. I suggest you stick to what you know best and I'll do the same.
As far as weekendtoy's latest post....the fact that you do not feel pain is a good indication that your condition is correctable and likely will not require surgical intervention (which is always the last option but sometimes necessary as in j_dem_bones' case). I would suggest that you stick closely to the exercise protocol provided by your therapist. You will probably fully recover within a couple months. Also, preventing further damage to the sub-patellar surface is a key component in the long term so always wear GOOD kneepads when you ride!!! Otherwise, you'll be right back in the therapists office in a couple of years! I hope my posts have been helpful. Take care and good luck!!!

 

[thump chump]

pop snapple crack...

... it is a good thing I'm not a burgular because of my knees. I pulled, stretched, and or tore a ligament/tendon (don't know which if it even one of those) turning direction in wet grass playing softball. It runs from the upper right inside of my knee accross to the middle of the kneecap. My knee also pops at about 3/4 flex and when it pops I feel a bit a numbness in that area to the outside bottom. Anyway, I've been taking spinning classes for over a year. But now the pain is so bad to whatever ligament/tendon, I can no longer do this. I just can't leave my knee in the same position for longer than 5 min before it starts aching. My ACL behind the knee is fairly loose as well.

SO TO MAKE A LONG STORY SHORTER-
Going to the Ortho doc next week. Just hope if he has to scope, that it won't take me out for long.