Rajesh Bhalla

Anterior Knee Pain

Term anterior knee pain is one of the most common health problems faced by an old person, sports person especially in adolescent females. Actually, anterior knee pain appears due to the breakdown of the cartilage of patella and trochlea (the distal end of the thigh bone, femur).

Anterior knee pain may be resolved via the strengthening of muscles & injection in younger patients on the contrary old age person need to undergo surgery.

Generally, unless a medical expert found a surgical problem in patient that is nonresponsive to the nonoperative treatment until they don’t ask for surgery. The condition that created anterior knee pain is known as Patellar chondromalacia.

What is Patellar Chondromalacia?

The pain around the anterior part of the knee occurs due to Patellar Chondromalacia. Patellar chondromalacia is abnormal softening of the cartilage of the kneecap. In the era of advanced technology now patellar chondromalacia refers to a specific diagnosis of the knee, which is a result of degeneration of cartilage due to poor alignment of Patella. The breakdown or degeneration of the cartilage of the patella causes severe knee pain in patients.

Degeneration in the cartilage of patella & trochlea (the distal end of the femur) could be a result of injuries, genetics or aging. The surface of the patella & trochlea in the healthy knee are smooth and joint fluid of knee creates an efficient gliding surface of 1/6 ice on ice. After degeneration of cartilage, this surface doesn’t exist that cause arthritis. Just because of early arthritis chondromalacia starts in knees.  

Symptoms of Patellar chondromalacia:

  • Anterior knee pain with motion
  • Active grinding occur on kneecap bone gliding
  • Swelling

There are some cases in which no symptoms were shown in Patellar chondromalacia in patients.

Some patients feel pain after long hours of sitting which is a common problem. Such patients face pain while long drive, sitting in one place for a long hour, sitting in the class room etc. Just after changing their sitting condition or small movements resolve knee pain may be a sign of anterior knee pain. There could a feel of grumbling pain sensations over long hour of standing or walking on rest.

What if anterior knee pain left untreated or ignored?

Well, having pain in front of the knee reveals that there is something wrong that should evaluate & be treated. If someone faces anterior knee pain that doesn’t go away even after the rehabilitation program, injections and rest then must undergo the surgical procedure of arthroscopic treatment. Once treatable problems of anterior knee pain get ignorance then over a time it may turn to worst or accelerated. Severe pain may limit the patient’s activities.

What are the treatments for patellar chondromalacia?

First of all, before starting treatment it is necessary to find out the cause of pain. Patients of anterior knee pain asked to follow x-rays, MRI scan to evaluate the cause of pain by medical experts. This is best in hand of knee preserving orthopaedic surgeons or cartilage surgeon.

Treatment of anterior knee pain may include activity modifications, rest, stretching, bracing, physiotherapy and arthroscopic surgery including medications.
Those patients who suffer from anterior knee pain can try to slow down the degeneration of cartilage by moderation in their activities and muscle strengthening programs.

Arthroscopic surgery involves the procedure of placing an instrument into the knee that shaves down unstable cartilage flaps on the patella and trochlear groove. After surgery physiotherapy improves the movement by strengthening the muscle of the knee. The patient must avoid such activities which can cause wear of cartilage, break down of cartilage or swelling in the knee.

Postoperative treatment of anterior knee pain

After Arthroscopic surgery the treatment requires to recovery from anterior knee pain is called post-operative treatment. It may include strengthening muscles, limiting swelling after surgery under the guidance of a surgeon guided physiotherapist. The most important part of post-operative treatment is to avoid swelling of the knee due to kneecap motion.

According to reports of some patients, it is found that the patients who have aggressive strengthening after surgery form an increased amount of scar tissue, leads to pain. That’s why after arthroscopic surgery it is suggested that to work on light low impact activities for the first 6 weeks. This should be observed under best knee specialist in Delhi or best orthopaedic doctor in Delhi.

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