Uneven patellofemoral joint wear.
Treating Chondromalacia Patella is quite a long term process and indeed, the very negative outcomes of not treating it can take a long time to come about. If CMP is allowed to go untreated for a lifetime, the cartilage on the rear, articulating surface of the patella / kneecap will wear unevenly, as in the picture to the right. Later in life, this is what ultimately brings about a good proportion of knee replacement surgery. Cartilage that wears away unevenly can also wear into a distinct ridge, resulting in the ledge flicking over the other bone as you take each step. This can give a clicking sound that occurs once with each step. Crunchy Knees are a little different to clicky knees.
Very small pieces of cartilage are ground off the patella vs femur (kneecap vs thigh bone) joint over the years due to uneven wearing patterns on a smaller area of the cartilage of either bone. This will stay floating within the joint fluid of the knee and make crunching noises as you walk – particularly up or down stairs stairs. Neither the crunching or the clicking will go away with time, even is your knee function is better aligned via foot orthotics as the floating bits of cartilage are not soluble and will stay suspended in the joint fluid indefinately. For more information about foot related knee pain, please browse to our Kneecap Pain Info Sheet. Alternately, use this link to return to our Podiatry FAQs Blog.
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