Patellofemoral chondropathy is an attack on the cartilage of the patellofemoral joint at the level of the knee. It can be perceived as an early form that can progress to osteoarthritis of the knee (gonarthrosis). Several therapeutic approaches are possible.

Definition of patellofemoral chondropathy

The patellofemoral joint is one of the knee joints: it forms the junction between the femur (thigh bone) and the patella (kneecap in the old nomenclature: small bone at the front of the knee). We speak of patellofemoral chondropathy, or patellar chondropathy, in case of wear or destruction of the cartilage of the patellofemoral joint.

Patellofemoral chondropathy is not the only knee chondropathy. There is also femorotibial chondropathy which defines cartilage damage at the femorotibial joint connecting the femur (thigh bone) to the tibia (leg bone).

In some publications, knee chrondopathy corresponds to osteoarthritis of the knee (gonarthrosis). In others, we talk more about chrondopathy in the early forms and osteoarthritis in the advanced forms.

Causes and risk factors

The origin of patellofemoral chondropathy is said to be polyfactorial. Its development is linked to the co-existence of various risk factors. Among them are in particular:

• genetic factors;
• the genu valgum which designates a deviation of the axis of the leg with the knees going inwards;
• the genu varum which refers to a deviation of the axis of the leg with the knees going outwards;
• excess weight which causes overloading of the joints;
• the frequent carrying of loads which also generates an overload at the level of the joints;
• the intensive and / or repeated practice of certain activities, with both a risk of microtrauma and a risk of overworking the joints and ligaments;
• knee trauma such as anterior cruciate ligament rupture and meniscus injury;
• certain metabolic diseases such as gout;
• certain inflammatory diseases such as rheumatoid arthritis;
• certain infectious pathologies such as infectious arthritis.

Diagnostic of the chondropathie fémoro-patellaire

The diagnosis of patellofemoral chondropathy is most often based on:

• a clinical examination with an interrogation in order to assess the type of pain, the discomfort felt or the mobility of the knee;
• medical imaging tests to assess the condition of the joint.

The diagnosis may require the intervention of a rheumatologist, a specialist in bone, muscle and joint disorders. 

People affected by patellofemoral chondropathy

The wear and tear of cartilage is a common phenomenon with age. Patellofemoral chondropathy is nevertheless not uncommon in young people who have a sport or a professional activity that strain the knees repeatedly.

At the onset of patellofemoral chondropathy, damage to the cartilage is minimal. They do not cause any symptoms.

Knee pain

As it develops, patellofemoral chondropathy manifests itself as gonalgia. It is a so-called mechanical knee pain which presents itself discontinuously. Gonalgia is mainly localized at the front of the knee but can manifest itself at the back of the patella (kneecap) during movement. The pain may be accentuated when squatting.

Possible discomfort

As it progresses, patellofemoral chondropathy can become restrictive on a daily basis. Severe knee pain may accompany certain movements, especially the squatting position.

The management of patellofemoral chondropathy consists of limiting its progression and relieving knee pain. To achieve this, several therapeutic approaches can be considered depending on the degree of cartilage damage, the pain felt and the risk factors identified:

• physiotherapy sessions;
• wearing a patellar orthosis, a device that will support joint function;
• nutritional and dietary support in the event of overweight;
• medication with analgesics to relieve pain;
• corticosteroid injections if necessary.

The prevention of patellofemoral chondropathy consists in limiting the avoidable risk factors as much as possible. It is therefore recommended to:

• maintain a healthy and balanced diet;
• maintain regular physical activity, while avoiding over-mobilizing the knee joints;
• reduce as much as possible the pressure exerted on the knee joints by improving, for example, the ergonomics of the workstation.