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Knee Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
This is often called “runner’s knee,” because the knee pain is often associated with running sports. It’s the number one cause of anterior knee pain in the United States with an incidence as high as one in four people (Laprade et al. 1998). The word chondromalacia is derived from the Greek words chrondros, meaning cartilage, and malakia, meaning softening. Chondromalacia patellae means a softening of the cartilage on the posterior surface of the patella which may eventually lead to fibrillation, fissuring, and erosion.
Paper 1
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 45 year old female patient has been referred to the orthopaedic service with anterior right knee pain, exacerbated by climbing stairs. A radiograph is unremarkable. Chondromalacia patellae is suspected clinically. The patient is mildly claustrophobic and the radiographer from the MRI scanner asks you which sequences you would like to prioritise in case the patient cannot tolerate the whole scan.
Substantive Issues in Running
Published in Christopher L. Vaughan, Biomechanics of Sport, 2020
Carol A. Putnam, John W. Kozey
Pain located in the anterior aspect of the knee has consistently been reported with the highest frequency in most running-injury studies. Clinically, it appears that the majority of the cases are diagnosed as chondromalacia patella (CMP).118 The clinical signs associated with CMP are pain, crepitus, and swelling during activities in which the patello-femoral forces are increased. In running, the phases of greatest knee extensor moment and therefore patello-femoral forces occur during stance phase (Figure 1). EMG data from most studies indicate activity in the knee extensors commencing prior to heel strike and continuing well into midstance (Figure 2). Therefore, one could expect the patello-femoral joint to be undergoing compressive and shear forces during this time.
The science of biomechanics can promote dancers’ injury prevention strategies
Published in Physical Therapy Reviews, 2021
Aspasia Fotaki, Athanasios Triantafyllou, Georgios Papagiannis, Sophia Stasi, Papathanasiou Georgios, Savvidou Olga, Charilaos K. Tsolakis, Panayiotis Koulouvaris
Serious or repetitive injuries can complicate or in some cases, even, terminate a dancer’s career [17,19]. Studies have shown that knee joint injuries are among the most frequent in dancers, because of the rotating loads that are applied to the joint. The elements, connective, or contractile, that surround and protect the knee are various and differ both in structure and function. An injury can include: stretching and/or irritation of the anterior cruciate ligaments, causing increased rotary instability of the joint and knee hyperextension; stretching and/or irritation of medial collateral ligaments, compromising the lateral stability of the joint; tearing or rupturing of the menisci; maltracking of the patella in the trochlear groove, resulting in grinding of the articular cartilage of the patellofemoral joint; increasing the incidence of chondromalacia patella and/or patellar tendonitis—‘jumper’s knee’ and predispose the joint to patellar dislocation [20–24].
A novel clinical test for assessing patellar cartilage changes and its correlation with magnetic resonance imaging and arthroscopy
Published in Physiotherapy Theory and Practice, 2019
Paul Khoo, Abhijeet Ghoshal, Damien Byrne, Ramesh Subramaniam, Raymond Moran
CMP is a condition characterized by softening, fraying, and ulceration of the patellar articular cartilage. Shahriaree (1985) describes it as a process of degeneration caused by frictional forces, which can occur in the absence of trauma. The process takes place gradually with the changes starting in the superficial layer and extending to the deeper regions of the cartilage with time. It is considered to be secondary to a progressive loss of ground substance and can be divided into four stages (Table 3). Between the third and the fourth stages, osteophytes develop at the margin of the articular surfaces where it joins the synovial membrane and capsular tissue. The condition is then more commonly referred to as osteoarthritis. Early degenerative changes are often not identified by radiography, as in the case of CMP. Therefore, in devising a clinical test, chondromalacia should be treated as a pathological entity of varying degrees of cartilage degeneration regardless of the presence or absence of symptoms such as anterior knee pain.
Outcome of isolated posterior cruciate ligament reconstruction at mean 6.3-year follow up: a consecutive case series
Published in The Physician and Sportsmedicine, 2019
Ryan C. Rauck, Benedict U. Nwachukwu, Answorth A. Allen, Russell F. Warren, David W. Altchek, Riley J. Williams
In total, 12 of the 15 knees (80%) underwent PCLR with a transtibial technique while three of 15 underwent tibial inlay, double bundle PCLR. Intra-operatively, chondromalacia was noted in 33% (5/15) of the cases. There were two cases with Outerbridge grade 3 chondromalacia to the medial femoral condyle and three cases with Outerbridge grade 1 chondromalacia. Concomitant procedures were performed in 20% (3/15) of cases with one medial meniscus repair, one partial medial meniscectomy and one repeat microfracture of the medial femoral condyle. Graft types included: quadriceps autograft (7 out of 15), Achilles allograft (6 out of 15), and hamstring autograft (2 out of 15) (Table 1).