Diagnosis
Your diagnosis is a lateral patellar compression syndrome with cartilage damage (chondrosis).
Injury or Condition
This condition represents an excessive lateral pressure which, over time, leads to premature cartilage cracking and erosion behind your kneecap (patella). The condition may worsen over time and is often present in both knees.
Cause
The most common cause is an excessively tight ligament (lateral retinaculum) which compresses the kneecap (patella) on its outer aspect (lateral facet) over many years.
Symptoms
Typical symptoms are a grinding sensation and pain with knee-bending activities like stair climbing. Swelling and tenderness along the lateral (outer) border of your kneecap (patella) are common.
Treatment
Standard treatment includes:
- Anti-inflammatory medication for 2-4 weeks (Diclofenac/Voltaren or Ibuprofen/Motrin).
- Avoiding activities that require deep knee bending, such as squatting or climbing.
- Long walks on level ground or terminal quadriceps exercises, like straight leg raises with 2-5 lb. ankle weights, can be helpful.
- Weight reduction relieves cartilage pressure.
- A knee sleeve, or a brace designed to take pressure off of the knee cap, may provide some relief.
- Arthroscopic surgery to release the excessively tight ligament and smooth damaged cartilage is often beneficial, especially if swelling, grinding and pain are persistant.
- Avoid knee extensions at the gym.
Precautions
Important precautions:
- Long term use of anti-inflammatory medication is generally not advised for this mechanical condition.
- Sporadic physical abuse, like backpacking downhill, may accelerate permanent cartilage damage.
- Recurrent swelling, even slight, often indicates deterioration or increasing damage to cartilage.
- If arthroscopic surgery is necessary, it is best performed before major damage to the patellar cartilage occurs.
Recovery
Recovery may occur gradually over 3 months. If arthroscopic surgery is performed, walking in a splint is prescribed for the first week, followed by physical therapy, then swimming and cycling. Return to competitive sports may require 4 months following surgery.
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