Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PreparePreop Lifestyle ChangesDay of SurgeryRecoveryLong Term Care
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
Preop Lifestyle Changes
Day of Surgery
Recovery
Long Term Care
The goal of the surgery is to help remove or fix damaged tissue and cartilage surrounding the knee. While there are less invasive options, these rarely will fix the underlying problem and you still may need surgery.
Utilizing physical therapy and taking time to heal will allow you to regain your knee’s full function and continue your daily activities. Speak to your healthcare provider to determine if surgery is the best option and what other treatment options are available.
Knowing the purpose of the surgery, surgical recovery time, risks, and contraindications can help you make an informed decision regarding chondromalacia surgery.
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What Is Chondromalacia Surgery?
Skilled orthopedic surgeons perform chondromalacia surgery to remove damaged cartilage. The goal of the surgery is to help remove or fix damaged tissue and cartilage surrounding the knee.
The surgical procedure can be done via arthroscopy or open knee surgery. The decision will ultimately be up to the orthopedic surgeon based on the severity of the damage. Arthroscopy is the more typical procedure, done as day surgery with minimally-invasive techniques.
At times, osteotomy needs to be performed to correct the alignment of the knee with the thighbone and shinbone. An osteotomy refers to the cutting of the bone, either the tibia (shinbone) or femur (thighbone). The bone is reshaped to relieve pressure on damaged cartilage and reduce the risk of further complications with the knee.
If an osteotomy needs to be performed, the surgeon may be more likely to make an open knee incision; however, a high tibial arthroscopic osteotomy can be performed. An overnight hospital stay may be needed for some patients.
Contraindications
Chondromalacia surgery is essential for most patients if physical therapy isn’t successful. Unfortunately, some patients cannot have this operation either because the knee is too damaged or they may need a total knee replacement. It will be important to discuss with your healthcare provider the pros and cons of the surgery and how they are specific to your medical condition.
Potential Risks
As with any surgical procedure, there are several potential risks associated with undergoing a surgical procedure. While most are relatively minor and treatable, early complications are:
More severe and possibly life-threatening complications include pulmonary embolism and deep vein thrombosis.
While rare, other possible complications of surgery include:
Purpose of Chondromalacia Surgery
Chondromalacia patellae, also known as “runner’s knee,” is a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens. The kneecap may start to rub against the femur and cause discomfort or pain.
Chondromalacia is seen as an overuse injury in sports. Taking time off and resting can help alleviate pain and reduce the risk of further injury. Other times, improper knee alignment is the cause and resting doesn’t provide relief.
Chondromalacia surgery is generally not a first-line procedure for this medical diagnosis. Your healthcare provider will suggest less invasive options first:
Before surgery, your surgeon will require several preoperative studies. These include:
It’s important to discuss with your healthcare provider the specifics of the surgery and what to expect during the postoperative phase. Ensuring you have realistic expectations for surgery is the key to success. Before surgery, have an open conversation with your surgeon.
You should contact your healthcare provider if:
Location
Chondromalacia surgery can be performed either in the hospital or an outpatient surgery center, depending on your surgeon’s preference as well as your baseline health. Most patients can expect to go home after recovering in the post-anesthesia care unit. However, some will have to spend at least one night in the hospital on a medical-surgical unit.
What to Wear
The most important thing to remember for this procedure is to dress comfortably. Medical professionals recommend loose-fitting clothing to wear to and from the hospital.
Most patients wear hospital gowns after the procedure due to the medical equipment, including IVs, catheters, drains, and you may have multiple knee incisions. You can expect to wear nonskid footwear at all times when out of bed.
Food and Drink
Take only the medications your healthcare provider tells you to take on the morning of your surgery. Take them with just enough water to swallow comfortably. Make sure to confirm the medications with your surgeon and only take them with water.
Medications
The surgeon will discuss all medications with you before the surgery. Make sure to bring a list of the medications to preoperative appointments, including the dosage, how often the medication is taken, and when it was last taken.
Also, include all vitamins and supplements in the list of medications. These are just as important as prescribed medications as they may have side effects with the anesthesia and medications used during and after the procedure.
Providers may start patients on medications before surgery to manage symptoms. These medications might include astool softenerto relieveconstipationto avoid straining, which can cause additional strain on the heart. An example of this medication isColace.
What to Bring
You will have more considerations for what to bring if you will spend a night at the hospital than if your surgery will be day surgery. Items may include:
If staying overnight, consider:
You should not bring:
Lifestyle changes are essential to the success of a patient having chondromalacia surgery.
It is important to start taking the proper steps prior to the surgery to make important lifestyle changes in order to prevent postoperative complications, improve healing, decrease inflammation, and decrease possible pain. Important changes include:
What to Expect on the Day of Surgery
Before the Surgery
On the day of the procedure, you will meet with the entire healthcare team, including surgeons, cardiologist,anesthesiologist, nurses, and physical therapist. All operative consent forms will be signed at this time to ensure you are fully prepared and do not have any additional questions or concerns.
The registered nurse will take vital signs, including:
Before going into the operating room for the procedure, patients will have preoperative tests done if needed. You will also be given a surgical soap that must be used on the surgical sites to properly cleanse the area and prevent infection.
After cleaning, you will be given a hospital gown, and the nurse will shave the surgical area if needed. The surgeon will mark the surgical site after you are fully prepped.
The nurse and surgical team will review your medications. Be prepared to discuss all of your medications, vitamins, and supplements at this time, including the dosages, the last time they were taken, and how often they are taken. Bringing a list of the information is helpful so nothing is missed.
Patients are instructed to empty their bladder before going into the operating room, remove all jewelry, glasses, contact lenses, and dentures, if applicable. Finally, the nurse will insert an intravenous catheter (IV) that will be used to provide hydration, medications, and anesthetics during the procedure.
During the Surgery
When it’s time for the surgery, you will be taken into the operating room on a stretcher and then placed onto the operating room table. You will then be prepared forgeneral anesthesia, which will last for the duration of the surgery. Before the operation begins, the following will take place:
After you are put to sleep, the surgeons will insert a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a video monitor.
The surgeon uses these images to guide surgical instruments to remove the damaged chondromalacia. Several additional small incisions will be made in the surrounding area to insert the other needed surgical instruments.
Most surgeons prefer to perform this procedure via arthroscopy; however, it can be done via an open mid-knee incision.
If the procedure is done via an open mid-knee incision, a flap is created, and spacers are used to pull back the skin, tissue, and muscle. This will expose the ligaments and bone structures.
An open incision may be indicated based on the severity of damage to the knee; however, some surgeons prefer this surgical method, as they suggest this provides a clearer view of the entire surgical field.
After the surgeon has located the area of the knee, it will be cut, shaved, or fixed depending on the severity of the damage. Once the knee is repaired, the surgeon will remove the instruments and close the incisions with sutures, derma bond (surgical glue), and Steri-Strips.
After the Surgery
All appropriate interventions will be given, and discharge instructions will be given. This will include postoperative pain medications and antibiotics, limitations, and future surgical appointments.
Some patients will have to spend the night in the hospital; therefore, the patient will be transported to a medical-surgical room for the night. Patients may see a physical therapist while in the hospital to cover exercises, braces, and crutch training. If patients are not spending the night, this will be taught preoperatively.
The recovery process will vary depending on the individual and the severity of the injury. Recovery after open-knee surgery is longer, and physical therapy is more intense than for those who have an arthroscopy procedure.
You will have a knee immobilizer or brace for two to four weeks after surgery, meaning that crutches or a wheelchair will be needed. Physical therapy will be started immediately following the procedure to work on range of motion exercises that will decrease swelling and reduce pain.
Most surgeons recommend no weight bearing for two weeks. You can do toe touching with crutches at two to six weeks while you can bear about 25% to 50% of your weight. Exercises with the physical therapist will help with weight-bearing exercises.
After about four to six weeks, you should be able to walk without crutches, but still while wearing a brace. By 12 weeks, you can be walking without a brace. Full recovery can take six to 12 months.
Healing
It is important to inspect your surgical incision and/or dressing several times a day during the healing process. You want to monitor for signs and symptoms of surgical site infection. If you cannot see the incisions yourself, you will need someone to assist you or have a visiting home care nurse come to perform incision checks.
Check your incision for any of the following:
If you experience any of the aforementioned symptoms or signs, it is imperative to call your surgeon immediately. Surgical site infections are serious but can be treated with antibiotics if identified early.
Coping With Recovery
One of the biggest challenges during postoperative time is pain management. You will be sent home with a prescription of narcotic pain medicine. Your surgeon will manage your pain management regimen. It is important to follow all recommendations precisely as given.
During the first week, you can expect to use narcotic pain killers to help manage your postoperative pain, as well as over-the-counter (OTC) pain medications such as Tylenol and Advil.
Over-the-Counter Pain Medications
OTC pain medications such asnonsteroidal anti-inflammatory drugs(NSAIDs), including Advil (ibuprofen), can be used in combination with other pain relievers.Tylenol(acetaminophen) is also commonly prescribed after surgery.
Prescription Pain Medications
For more intense pain and during the first few days after surgery, you will be prescribed anopioid drugsuch as Percocet, Vicodin, orOxycontinto ease your pain. It’s important to note that these are highly addictive and should be taken only as directed.
You may experience the followingside effectswhile taking prescription pain medication:
It is recommended that all unused prescription pain medication be disposed of properly or returned to the pharmacy.
Nonmedical Approaches
Complementary therapies such asaromatherapy, meditation, and/or guided imagery can be helpful during the recovery process. It’s important to remember that these alternative approaches should not replace needed pain medication but rather should act in conjunction with your doctor’s pain management regimen.
While you may want to attempt recovery with little to no medication, it is also important to remember to listen to your body. Untreated pain can cause numerous physical complications and should not be ignored.
Doctors recommend trying distraction—listening to your favorite music, playing board games, or card games. This may ease anxiety or stress as a means to get your mind off the pain.
Another approach is the use ofguided imagery. This involves closing your eyes, breathing very deeply, and picturing yourself in an ideal location or a “happy place.” Over time, you should be able to feel positive emotions from where you are, leaving you calmer and more in control.
Surgery can be physically, mentally, and emotionally exhausting. However, it is essential to follow all of your surgeon’s recommendations to prevent further damage and complications to the surgical area.
Maintaining the physical therapy regimen as well as healthy lifestyle will help with wound healing, range of motion, and pain management.
Possible Future Surgeries
Because this surgery is more common in younger people, it is possible that you may need to have additional surgeries. Furthermore, this surgery does not prevent you from injuring the same knee or needing the same surgery again.
The goal of the surgery and therapies after are to strengthen the knee, surrounding muscle, and ligaments to prevent the injury from reoccurring. Unfortunately, some people are injured again.
Lifestyle Adjustments
Some individuals will be advised to make significant lifestyle changes to minimize the risk of additional knee problems and future surgeries. For example, it might be recommended to switch to lower-impact sports to decrease the amount of pressure placed on the knees, surrounding cartilage, and tissue.
A Word From Verywell
Chondromalacia surgery can be overwhelming, especially because it will affect your ability to walk, drive, and potentially care for yourself as you recover. Having the support of close friends and family during the postoperative period is the key to success.
Discuss with your healthcare provider all viable options before jumping to surgery as nonoperative interventions such as rest, ice, NSAIDs, and physical therapy might be possible options.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD.Complications after arthroscopic knee surgery.The American Journal of Sports Medicine. 2014;42(2), 292-296. doi:10.1177/0363546513510677Nevada Orthopedic & Spine Center.Chondromalacia patella.MedlinePlus.Stool softeners.American Academy of Orthopaedic Surgeons.Knee arthroscopy.Orthopedic Specialists of North Country.Recovery from arthroscopic knee repair surgery.Johns Hopkins Medicine.Surgical site infections.Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M.Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial.Geriatrics (Basel). 2020 Sep 16;5(3):53. doi:10.3390/geriatrics5030053
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD.Complications after arthroscopic knee surgery.The American Journal of Sports Medicine. 2014;42(2), 292-296. doi:10.1177/0363546513510677Nevada Orthopedic & Spine Center.Chondromalacia patella.MedlinePlus.Stool softeners.American Academy of Orthopaedic Surgeons.Knee arthroscopy.Orthopedic Specialists of North Country.Recovery from arthroscopic knee repair surgery.Johns Hopkins Medicine.Surgical site infections.Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M.Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial.Geriatrics (Basel). 2020 Sep 16;5(3):53. doi:10.3390/geriatrics5030053
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD.Complications after arthroscopic knee surgery.The American Journal of Sports Medicine. 2014;42(2), 292-296. doi:10.1177/0363546513510677Nevada Orthopedic & Spine Center.Chondromalacia patella.MedlinePlus.Stool softeners.American Academy of Orthopaedic Surgeons.Knee arthroscopy.Orthopedic Specialists of North Country.Recovery from arthroscopic knee repair surgery.Johns Hopkins Medicine.Surgical site infections.Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M.Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial.Geriatrics (Basel). 2020 Sep 16;5(3):53. doi:10.3390/geriatrics5030053
Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD.Complications after arthroscopic knee surgery.The American Journal of Sports Medicine. 2014;42(2), 292-296. doi:10.1177/0363546513510677
Nevada Orthopedic & Spine Center.Chondromalacia patella.
MedlinePlus.Stool softeners.
American Academy of Orthopaedic Surgeons.Knee arthroscopy.
Orthopedic Specialists of North Country.Recovery from arthroscopic knee repair surgery.
Johns Hopkins Medicine.Surgical site infections.
Aghbolagh MG, Bahrami T, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Vaismoradi M.Comparison of the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis: A randomized controlled clinical trial.Geriatrics (Basel). 2020 Sep 16;5(3):53. doi:10.3390/geriatrics5030053
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