Prospective study of 105 arthrotomies for chondromalacia patellae at HSS, examining the anatomic patterns of cartilage damage, the role of patellar malalignment as a causative factor, and the outcomes of patellar realignment combined with cartilage excision or shaving.
When evaluating a young patient with anterior knee pain, assess Q angle (abnormal ≥20°) and obtain a lateral radiograph to measure the Insall-Salvati ratio for patella alta — malalignment in either form is the most common underlying cause and guides surgical planning.
Intraoperatively, expect cartilage damage to be central and equally distributed across medial and lateral facets rather than isolated to the medial facet, so adequate exposure for complete patellar visualization is essential.
Prospective study of 105 arthrotomies for chondromalacia patellae at HSS, examining the anatomic patterns of cartilage damage, the role of patellar malalignment as a causative factor, and the outcomes of patellar realignment combined with cartilage excision or shaving.
When evaluating a young patient with anterior knee pain, assess Q angle (abnormal ≥20°) and obtain a lateral radiograph to measure the Insall-Salvati ratio for patella alta — malalignment in either form is the most common underlying cause and guides surgical planning.
Intraoperatively, expect cartilage damage to be central and equally distributed across medial and lateral facets rather than isolated to the medial facet, so adequate exposure for complete patellar visualization is essential.