Glossary

Chondromalacia

Quick answer

Chondromalacia literally means softening of cartilage. On knee reports it describes cartilage that has softened, frayed or worn, most often behind the kneecap, and it is graded from 1 to 4 by depth. It is common and often manageable with exercise, says Doha knee surgeon Dr. Pablo Gelber at Aman Hospital.

What the grades mean

Grade 1: softening or swelling of the cartilage surface.
Grade 2: fraying or fissures in less than half the cartilage depth.
Grade 3: fissures or loss reaching more than half the depth.
Grade 4: cartilage worn through to exposed bone.

When the word appears with patella, the change is on the back of the kneecap. It may also be reported on the trochlea or the femoral condyles.

Does it matter?

Low grades are very common on MRI, including in people without pain, so a report alone does not explain symptoms. When it does cause trouble, the typical complaint is an ache at the front of the knee on stairs, squatting, kneeling for prayer or after sitting for a long time.

Higher grades over a wider area overlap with osteoarthritis of the kneecap joint.

How it is treated

Most people improve with strengthening of the quadriceps and hip muscles, adjusting load and footwear, and weight management where relevant. Correcting maltracking or alignment problems can help. Surgery is uncommon and usually reserved for specific structural causes or focal deep defects.

Frequently asked questions

Is chondromalacia the same as arthritis?

Early grades are softening and fraying, not arthritis. Grade 4 chondromalacia over a wide area is effectively osteoarthritis of that part of the knee.

Can chondromalacia be reversed?

Worn cartilage does not regrow, but symptoms often settle with a good exercise programme, and many people return to sport and daily life comfortably.