Kneecap pain or anterior knee pain, is in most cases this is due to a condition called Chondromalacia Patellae (CMP). In this condition, the articular cartilage just behind the kneecap becomes soft. Symptoms are made worse by climbing stairs, descending stairs, prolonged sitting and often by activities such as jogging. It is quite common in actively growing adolescents and in certain sports that involve prolonged running.
If there are no background or anatomical problems, then it is usually treated by physiotherapy to strengthen the muscles around the knee. As it often occurs in patients with a lax joints, the use of orthotics to improve the biomechanics of the joint are also employed. This can take the form of braces or supports around the kneecap but also inserts in the shoes can quite dramatically changed the way forces are transmitted across the knee joint and can be very helpful.
The situation can be confused further inasmuch as even minor degrees of CMP can cause apparently quite severe pain. Paradoxically some people with very severe CMP have no symptoms at all. It is therefore difficult to measure by investigations such as MRI to what extent a patient is troubled. It is often therefore a clinical decision on who and how far to treat this condition.
It is often a self limiting condition and although it can be quite painful.
Where there is no structural damage or anatomical abnormality, surgery does not really have a role. Whilst a number of procedures have been proposed to deal with this condition, they are in general very unpredictable and in certain circumstances can actually make the problem worse. Therefore conservative treatment of this condition is always recommended as the first line of treatment.
Where surgery is contemplated, it is usually in the situation where there is now tracking of the patella. The surgical options will be discussed in that section.