[Neurologic component and resulting therapeutic concept of patellar chondropathy and chondromalacia]

Observations of nerve root lesions in spontaneous peripatellar pain led to new aspects concerning the etiology of periarticular pain and chondromalacia patellae. We regard the spontaneous peripatellar pain as an enthesiopathia resulting from an innervation disorder. We believe that also chondromalacia can be caused by nerve root lesions. As a consequence, a change in conservative and operative management is necessary. The aim is a balanced gliding and rotational stability of the patella. This means a muscular compensation of the weakened muscle part and stabilisation of the lumbar and hip region. Surgical techniques should only be applied to normalize the gliding of the patella. There is no indication for ventralisation of tuberositas tibiae.