Chondromalacia Patellae

(Patellofemoral Syndrome)

ByFrank Pessler, MD, PhD, Helmholtz Centre for Infection Research
Reviewed/Revised Dec 2022
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Chondromalacia patellae is softening of the cartilage under the kneecap (patella), causing knee pain.

Chondromalacia patellae typically develops in adolescents. Joggers are especially susceptible. The cause of chondromalacia patellae is probably a minor, repetitive injury resulting from misalignment of the kneecap. The misalignment causes the cartilage on the underside of the kneecap to grate against other bones when the knee bends.

Inside the Knee (Side View)

Dull, aching pain is felt all around and behind the knee. There is no swelling. Climbing (especially going up or down stairs), playing certain sports, sitting for a long time, and running usually worsen the pain.

A doctor bases the diagnosis of chondromalacia patellae on the symptoms and a physical examination.

Treatment of Chondromalacia Patellae

  • Strengthening and stretching exercises

  • Anti-inflammatory drugs

  • Sometimes arthroscopic procedures

The doctor may recommend exercises to strengthen the quadriceps muscles, which straighten or extend the knee joint. Increasing knee flexibility with stretching exercises helps. Activities that worsen the pain (typically those that involve bending the knee) should be avoided for several days.

Ice and nonsteroidal anti-inflammatory drugs

Occasionally, the undersurface of the kneecap must be smoothed with a small (about the diameter of a pencil) fiberoptic scope called an arthroscope, which allows the doctor to look inside the joint.

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