San Antonio, TX
A 60-year-old female asked:

Extensive grade iv patellar chondromalacia particularly along median patellar ridge & medial patellar facet. there is evidence for patella alta. so, what does this mean, & do i need knee replacement?

3 doctor answers8 doctors weighed in
Dr. Frank Holmes
Sports Medicine 25 years experience
Loss of cartilage: Chondromalacia means loss and/or damage to the cartilage that covers the bone. In your case, you have damage on the back and inside of the kneecap, and grade IV is the most severe grade of injury/loss. Patella alta means the kneecap is sitting higher (closer to the hip) than it normally should. We treat patients, not necessarily mris. How you are treated depends on your symptoms and disability.
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Dr. Nolan Segal
A Verified Doctoranswered
A US doctor answeredLearn more
No: You have patellofemoral disease. You might be able to avoid knee replacement surgery. If the weight-bearing surfaces are involved as well that is a different story. Isometric quadriceps strengthening exercises can help. A patellar stabilizing knee sleeve also might help. Avoid squatting crawling kneeling and repetitive stairs.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. David Brouwer
Internal Medicine 32 years experience
Orthopedist: Further orthopedic consultation will help guide your decision. Your kneecap (patella) is resting higher than normal (alta) and has calcified arthritic changes (chondromalacia). There are some non-surgical options including physical therapy, but your orthopedist will have to clarify what your best option is.
Created for people with ongoing healthcare needs but benefits everyone.
Dr. Peter Ihle
Dr. Peter Ihle commented
Orthopedic Surgery 56 years experience
U need2B patient with Ur treatment plan. Often different things R tried along the way. It may seem U R an experiment, but have confidence .
Apr 20, 2013
Last updated Apr 16, 2021


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