A preliminary investigation: History, physical, and isokinetic exam results versus arthroscopic diagnosis of chondromalacia patella

The purpose of this pilot study was to identify those clinical exam findings most often seen in patients with a positive chondromalacia patella (CMP) arthroscopic exam. Twenty patients with a clinical diagnosis of CMP or meniscal lesions (M) or both (CMP+M) were evaluated by two physical therapists using the history, physical, and Cybex II® isokinetic testing data. More than 50% of the patients with arthroscopically confirmed CMP complained of peripatellar pain, pain with ascending and descending stairs, and pain with prolonged flexion. At least 50% of these patients also demonstrated pain with a patellar grinding test and crepitus during the active knee extension test. Chi square analysis of the clinical exam data beween the arthroscopically diagnosed CMP+M patients and 20 age- and sex-matched normal subjects revealed a significant difference in response to the three history questions analyzed. No significant differences were found on the physical exam, including Cybex II isokinetic testing results. Our findings demonstrate the significant role of the history in diagnosing symptomatic CMP.