Anterior knee pain

When the cartilage behind the kneecap (patella) becomes damaged, it causes a painful condition known as chondropathia patellae. This anterior knee pain often affects adolescents aged between 13 and 15, when their bodies are growing most rapidly. People who play sports that put a lot of pressure and strain on the knees (skiing, football) and those who regularly work on their knees are also at risk of damaging the cartilage behind their kneecaps.

Exactly how and why this cartilage damage occurs is largely unknown. However, it is clear that certain factors – such as rapid growth during puberty and chronic strain caused by some sports and occupations – can lead to tears and degenerative changes on the rear side of the kneecap.

Initially, the cartilage damage does not cause any symptoms. But over time, it can produce pain behind the kneecap that becomes worse when pressure is exerted on the kneecap. This is often followed by swelling or a build-up of fluid around the knee joint. The symptoms become worse when the knee is bent, such as when walking up stairs. Sometimes a rubbing sensation can be felt (or even heard) when the knee is bent and extended.

Chondropathia patellae is diagnosed on the basis of these typical symptoms and an examination of the knee joint. The diagnosis is confirmed using an x-ray or MRI examination, or occasionally with knee joint imaging.

Anterior knee pain can usually be treated conservatively, in other words, without an operation. At the start of the treatment, the knee joint and kneecap are rested and possibly bound with bandages to further reduce any strain.  Therapeutic stretching exercises and special training to strengthen the thigh muscles help to reduce the pressure on the kneecap. If treated promptly, the problem can be resolved and further degeneration (which could result in osteoarthritis) can be prevented.

Surgery is only used in rare cases when conservative treatments show no signs of success.