Chondromalacia Patella

It is easy to twist a knee, bang a knee, land the wrong way, there is a lot of reasons, arthritis comes up, those are some of the reasons. Also a lot of Chondromalacia patella, that is where the knee bone kind of cracks a little bit against the femur, the thigh bone.

Chondromalacia patella. Malacia means break down, condro means cartilage, patella means the back of the knee bone, which is call the patella, (and there) is the thickest cartilage in the body. It starts rubbing the wrong way against the tract that it slides in and with repetitive use like running or stair climbing, things of that nature, any sport really, the repetitive use just wears out the back of that knee cap and begins the arthritis process and pain. This is also one of the easiest things to heal with Prolotherapy. It is usually just a couple of injections with sugar water and it starts a little inflammatory cycle and builds up collagen there.

The patella, commonly called the kneecap, sits in a groove at the front of the knee. The most common knee problems encountered in clinical practice involve the patella, because its anatomical placement subjects it directly to a variety of bony and soft tissue disorders.

A portion of the general population is subject to these disorders, which include:

• Patellofemoral syndrome (patella mistracks in femoral groove);
• Excessive torsional deformity of the tibia;
• High or lateral position of the patella;
• Shallow femoral trochlea;
• Atrophy of vastus medialus oblique muscle;
• Increased quadriceps angle (often in those with wide hips);
• Over-development of the vastus lateralis muscles;
• Flat feet;
• Excessive pronation of the feet (feet turn up to the side).

Behind the patella is a layer of articular cartilage-the thickest layer of cartilage found in any of the joints of the body.

Until recently, we did not know that cartilage is directly treatable by trigger point injections and Prolotherapy. We knew the benefits that Prolotherapy Injections offered in adjoining soft tissue, due to the strengthening of the supporting ligaments and tendons, which keep the joints properly aligned and thereby protect the cartilage from erosion caused by friction.

A recent study, showed that Prolotherapy stimulates the growth of articulate cartilage. (Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med 2000 Mar;6(2):68-74, 77-80. )

In this study, people who had knee arthritis, and, who suffered from knee pain for an average of eight years or more, received Prolotherapy over a six month period. Important to note is that 35% of the knees examined for the study had no cartilage remaining in one or more major compartments.

The results? Thirty-five percent (35%) reduction of pain, 45% improvement in swelling and 67% improvement in knee buckling as well as a 13 degree improvement in knee range of motion.

Prolotherapy works on most knee problems with excellent results. Only in the case of a completely torn ligament is Prolotherapy somewhat limited. If there is a partial tear (sometimes on MRI these may look like complete tears) Prolotherapy maybe able to reconstruct the ligament and strengthen the joint. But even with a complete tear, Prolotherapy is extremely beneficial because an impact with enough force to completely rupture a ligament will also loosen the entire knee structure. Prolotherapy in this situation can strengthen the surrounding tissues giving the patient a better chance of long-term success. It is rare that a patient who is not active in sports or a competitive athlete needs ACL surgery. Many athletes function on an ACL deficient knee.

Discussions from our Radio Show about Chonfromalacia Patella:

Caller: I am having some inflammation and knee pain after working out, I am 52.

Dr. Darrow: By 52 the collagen in the body has started to break down. For most collagen breakdown becomes noticeable in our 40′s as we start getting wrinkles around our eyes and on our faces.

As we see in the skin on our faces, the collagen in our knees starts to go and as we continue to work out there is obviously stress on the joint.

Most knee pain that we see is called Chondromalacia patella. Malacia means break down, condro means cartilage, patella means the back of the knee bone, which is called the patella, (and there) is the thickest cartilage in the body. It starts rubbing the wrong way against the tract that it slides in and with repetitive use like running or stair climbing, things of that nature, any sport really, the repetitive use just wears out the back of that knee cap and begins the arthritis process and pain.

It is also made worse when you are sitting in a movie theater or you are in an airplane and stuck in one place for a long period of time. Often times people can have a little meniscus tear, the meniscus is a little cushion inside the knee. Prolotherapy helps grow back all of this tissue.

Before you decide on surgery, explore Prolotherapy, because of all the things Prolotherapy works on, it works fastest in the knees.