What is the Difference Between Chondromalacia Patella and Patellofemoral Pain Syndrome?

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Chondromalacia patella and patellofemoral pain syndrome (PFPS) are related but distinct conditions affecting the knee. Here are the main differences between the two:

Chondromalacia Patella:

  • Refers to the softening and breakdown of the articular cartilage on the underside of the kneecap.
  • There are no nerves in the articular cartilage, so damage to the cartilage itself cannot directly cause pain.
  • It can lead to inflammation of the synovium and pain in the underlying bone.
  • Main symptom is anterior knee pain, exacerbated by activities that load the patellofemoral joint, such as running, stair climbing, squatting, kneeling, or changing from a sitting to a standing position.
  • Other symptoms include tenderness on palpating under the medial or lateral border of the patella, crepitation (felt with motion), minor swelling, a weak vastus medialis muscle, and a high Q-angle.

Patellofemoral Pain Syndrome (PFPS):

  • A broad term used to describe pain in the front of the knee or kneecap, sometimes called "runner's knee" or "jumper's knee".
  • Occurs when nerves sense pain in the soft tissues and bone around the knee, including the tendons, the fat pad beneath the patella, and the synovial tissue that lines the knee joint.
  • Can be caused by abnormal tracking of the kneecap in the trochlear groove, leading to increased pressure between the back of the patella and the trochlea, irritating soft tissues.
  • Pain and stiffness caused by PFPS can make it difficult to climb stairs, kneel down, and perform other everyday activities.

In some cases of patellofemoral pain, chondromalacia patella is present. While the conditions are related, they have distinct characteristics and symptoms.

Comparative Table: Chondromalacia Patella vs Patellofemoral Pain Syndrome

Chondromalacia patella and patellofemoral pain syndrome are two medical conditions that cause knee pain. Here is a table comparing the differences between the two:

Feature Chondromalacia Patella Patellofemoral Pain Syndrome
Age Group Mainly affects adults Can affect both children and adults
Knee Pain Pain in the front of the knee, aggravated by sitting for long periods, going up and down stairs, and deep knee bending Knee pain due to malalignment of the femur to the patella and tibia, often seen in athletes
Caused By Malalignment of the femur to the patella and tibia Overload injury, such as cartilage softening or irregularity
Symptoms Pain, stiffness, and swelling in the knee joint Pain, tenderness, and sometimes a crackling sound when the knee is moved
Treatment Physical therapy, strengthening exercises, and avoiding activities that compress the patella Physical therapy, strengthening and stability exercises, and sometimes surgery

In summary, chondromalacia patella is a condition that mainly affects adults and is caused by malalignment of the femur to the patella and tibia, leading to pain in the front of the knee. Patellofemoral pain syndrome, on the other hand, can affect both children and adults and is often seen in athletes. It is caused by an overload injury, such as cartilage softening or irregularity, and results in knee pain due to malalignment.