Chondromalacia

When bone cartilage softens and inhibits smooth movement of the joint. Articular cartilage can soften as a result of a fracture, poorly aligned tissue or bones in the joint, an infection in the ankle, osteoarthritis and numerous wear-and-tear stress injuries.

What is it?

The bones in any joint are covered with a hard, slick surface called articular cartilage, which is designed to enable smooth movement. If the cartilage becomes soft, it no longer works properly, and is liable to get worn away. Articular cartilage can soften as a result of a fracture, poorly aligned tissue or bones in the joint, an infection in the ankle, osteoarthritis and numerous wear-and-tear stress injuries. The damaged cartilage does not re-build itself when damaged. Movement becomes inhibited and painful when the cartilage has worn through and the bones are exposed. Chondromalacia commonly occurs in sportspeople who stress their ankles a lot.

How does it feel?

A dull, aching pain and stiffness in the ankle joint, which can flare up if you have been sitting still for a long time. You may feel as though your joint ‘catches’ as you try to move it past a certain point. Your ankle might also feel as though it will give way. It can cause a creaky sound or grinding sensation when you move it. There may be some swelling.

Diagnosis

A physical examination will ascertain the range of movement, and comparison with the other ankle will indicate swelling. An MRI scan will be used to see whether there is damage to the cartilage. An arthroscopic diagnosis might also be necessary to ascertain which tissues have been affected, and the extent of the damage.

Surgery

During arthroscopic surgery, damaged layers of cartilage can be removed leaving the healthy cartilage in place. If the cartilage has been damaged as a result of mis-alignment of muscles or bones, this will be corrected during surgery.

If there is damage to the bone beneath the cartilage, micro-fracturing technique (creating tiny fractures in the surface of the bones around the damaged cartilage) can be used to stimulate healing.

Recovery

You should be able to put weight on the ankle immediately after surgery. You will need to rest and ice it for 48 hours, after which your physiotherapy programme will start. Physiotherapy can last up to six weeks.

If the surgeon has carried out , you may need to use crutches for up to six weeks after the operation.

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