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Author Topic: What's the difference OA / Chondromalacia ?  (Read 9097 times)

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What's the difference OA / Chondromalacia ?
« on: January 30, 2006, 04:06:58 PM »
Hi everyone

I can't get my head around this one no matter how much I read! Can anyone please tell me the difference between osteoarthritis and Chondromalacia as to me they appear to be the same?

Thnx

Offline shade

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Re: What's the difference OA / Chondromalacia ?
« Reply #1 on: January 30, 2006, 05:14:11 PM »
Hi,

This is what I found - might help.......

Chondromalacia patellae is a mild form of osteoarthritis, common in children and young adolescents. It affects the cartilage on the back of the kneecap (patella) and causes pain and stiffness, especially when going up and down stairs. Unless the inner load-bearing surface of the kneecap has been severely damaged, the outlook is generally good.
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Offline blackbeltgirl

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Re: What's the difference OA / Chondromalacia ?
« Reply #2 on: January 30, 2006, 05:31:07 PM »
Some doctors will refer to chondo as "pre-arthritis".  Overall, there's not much difference.  They are graded on the same basic scale, with 4 meaning the cartilage has worn comopletely away and the bone is exposed.  Some doctors will use the term chondro for younger patients, or if the damage is confined to just 1 compartment, or focal lesions (potholes), and the term arthritis for older patients, or if they see degenerative changes throughout the entire knee.  But, when push comes to shove, both terms mean the wearing away of the articular cartilage.
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Re: What's the difference OA / Chondromalacia ?
« Reply #3 on: January 31, 2006, 10:03:54 AM »
Thanks Shade and BBG

That clears that one up then!  :D

Offline Heather M.

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Re: What's the difference OA / Chondromalacia ?
« Reply #4 on: February 02, 2006, 07:55:31 AM »
My doctor uses a descriptive system that treats chondromalacia (well, chondral defects--he doesn't use the term chondro anymore) and OA as different points on the same continuum; the continuum or journey is often called generically osteoarthritis, and the terminal point is a condition called "degenerative joint disease."

Imagine skinned knee vs a deep cut or laceration vs laying open your knee in a serious injury.  This kind of covers the differences between the conceptsof chondro vs OA vs DJD. 

One thing to keep in mind is that many patients can and do progress from the simplest forme--chondral damage or so-called chondromalacia--to the next phase of severity, which would be going through the chondral layer with damage so deep it is into the underlying bone.  That would be osteoarthritis.

Keep in mind something else, though....not all doctors subscribe to this particular terminology.  I saw a second opinion guy about 15 months ago and said I had grade II osteochondral lesions (meaning OA) and he told me "Those words have no meaning to me."  I pointed out that they came from an op report written by a highly regarded doctor in the neighboring state, and maybe they all should get together and talk about stuff over drinks and/or golf at the upcoming regional medical conventions.  Dr. Grelsamer in NYC has also pointed to the difficulties posed by a lack of standardized terminology.  It's frustrating for the doc, so imagine the patient!!!

So anyway, here's a pretty good overview of terminology and how SOME doctors rate the level of damage.  Chondral damage is the least severe, seeing as it deals with the articular cartilage coating and protecting the bone.  Osteochondral damage is a bigger problem because the chondral layer and its protected properties have been breeched, allowing damage to settle into bone (osteo or osseous injury).  This is osteoarthritis, also known as arthritis, and it is a mechanical problem--the parts are wearing out to due early /abnormal wear and tear.  This is different from RA or rheumatoid arthritis, which is a genetic condition related to immune probelms--the joints wear out, but more because the body attacks itself through inflammatory enzymes in a poorly understood disease.  OA is also a disease, but it can be precipitated by something we do to ourselves--overuse injuries, tendinitis, etc., or by stuff we are victims of such as post-op infection, excess scar tissue.

Okay, enough tired babble...I'm on night four of complete inability to sleep.  I want to do it, but something always gets in the way.  Last night it was a sick dog, the night before a plugged toilet (oh, joy), the night before my mind just wouldn't shut off....so I'm so tired I'm swaying as a type this.  But hopefully these links will help explain a bit:

http://www.steadman-hawkins.com/knee_chondral/overview.asp  Be sure to go through all 6 tabs, including FAQs

http://www.kneehippain.com/patient/i_patellarpain.html

Good luck with the education process--it's critical to ensuring you get the right treatment.

Heather
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Re: What's the difference OA / Chondromalacia ?
« Reply #5 on: February 02, 2006, 09:02:26 AM »
Thanks Heather

You certainly know you stuff! THanks so much for the info. I hope you dog is ok and that your loo is behaving itself! lol

Have a great day
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