Chondromalacia patellae: current options and emerging cell therapies

Abstract

Chondromalacia patellae (CMP), also known as runner’s knee, typically occurs in young patients, which is characterized by anterior knee pain (AKP) that is associated with visible changes in patellar cartilage. The initial pathological changes include cartilage softening, swelling, and edema. CMP is caused by several factors, including trauma, increased cartilage vulnerability, patellofemoral instability, bony anatomic variations, abnormal patellar kinematics, and occupation hazards. CMP may be reversible or may progress to develop patellofemoral osteoarthritis. Quadriceps wasting, patellofemoral crepitus, and effusion are obvious clinical indications. Additionally, radiological examinations are also necessary for diagnosis. Magnetic resonance imaging (MRI) is a non-invasive diagnostic method, which holds a promise in having the unique ability to potentially identify cartilage lesions. Modalities are conventionally proposed to treat cartilage lesions in the PF joint, but none have emerged as a gold standard, neither to alleviated symptoms and function nor to prevent OA degeneration. Recently, researchers have been focused on cartilage-targeted therapy. Various efforts including cell therapy and tissue emerge for cartilage regeneration exhibit as the promising regime, especially in the application of mesenchymal stem cells (MSCs). Intra-articular injections of variously sourced MSC are found safe and beneficial for treating CMP with improved clinical parameters, less invasiveness, symptomatic relief, and reduced inflammation. The mechanism of MSC injection remains further clinical investigation and is tremendously promising for CMP treatment. In this short review, etiology, MRI diagnosis, and treatment in CMP, especially the treatment of the cell-based therapies, are reviewed.

Association between the subcutaneous fat thickness of the knee and chondromalacia patella: a magnetic resonance imaging-based study

“…Trauma, patellofemoral instability (subluxation or dislocation), increased cartilage vulnerability (congenital conditions and the postarthrotomy rehabilitative period), abnormal kinematics of the patella (e.g., patella alta, knees with valgus deformity), and certain anatomical variations of the bone (osteochondral ridge and flattened lateral femoral condyle) are factors that play a role in the etiology of CP. 15 In a study with a large series of patients (n ¼ 301), the sulcus angle, patellar angle, trochlear depth, and patellar tilt were measured to investigate a possible relationship between these anatomical factors and CP. The trochlear depth and lateral patellar tilt angle were significantly lower and the sulcus angle was higher in patients with than without CP.…”

Condromalácia Patelar E Desequilíbrios Musculares: Papel Da Reabilitação Muscular Na Melhoria Dos Sistemas E Prevenção De Recorrência

“…Outros pacientes do sexo feminino apresentam uma espessura do tecido adiposo subcutâneo do joelho maior e CMP mais graves que ocorrido nos pacientes masculinos (Zheng et al, 2021).…”

Mesenchymal Stem Cell-Derived Apoptotic Bodies: Biological Functions and Therapeutic Potential

“…So far, MSCs have been successfully isolated from a variety of tissues including dental pulp [ 2 ], periodontal ligament [ 3 ], adipose [ 4 ], synovial fluid [ 5 ], umbilical cord [ 6 ], and amniotic fluid [ 7 ]. MSCs have the ability to differentiate into osteoblasts [ 8 ], chondrocytes [ 9 ], adipocytes [ 10 ], vascular endothelial cells [ 11 ], cardiomyocytes [ 12 ], and neuronal cells [ 13 ]. Due to multidirectional differentiation potential, MSCs-based therapy seems superior in disease treatment.…”