Understanding Chondromalacia and The Problems Facing Andrew Bogut

The Warriors currently hold the best record in the NBA but maintaining that success will be difficult with center Andrew Bogut sidelined for the foreseeable future. Bogut recently underwent a platelet-rich plasma (PRP) injection in his ailing right knee, a procedure designed to facilitate and accelerate the body’s natural immune response.

PRP is becoming commonplace in the NBA and isn’t the reason Golden State should be worried about Bogut. The bigger problem is the reason for the injection, a condition known as chondromalacia.

Chondromalacia occurs when there is cartilage damage to the knee, usually on the underside of the kneecap. The smooth cartilage here is a vital component of knee movement, allowing for the kneecap to efficiently move while protecting the surface of the knee joint. If the cartilage softens or becomes eroded, the bone becomes uncovered and is easily irritated or damaged. The resulting damage elicits pain and inflammation in the effected individual. Furthermore, any cartilage damage would inhibit the knee’s ability to absorb and disperse the various amounts of shock and stress put on and through the joint. As a result the knee becomes susceptible to other chronic conditions like tendinitis or arthritis.

Chondromalacia often develops from overuse or poor biomechanics at the knee and is generally treated in a conservative (non-surgical) approach. However, surgery would be considered should the damage of the cartilage be too severe or if a significant misalignment of the knee is the source of the problem. Microfracture surgery is a potential option as the procedure is intended to stimulate growth of cartilage, a tough tissue to naturally regenerate.

Chondromalacia is a relatively common problem in the NBA and Golden State’s own Andre Iguodala has previously dealt with the problem in his right knee. Iguodala received his diagnosis during the 2010-11 season while a member of the Philadelphia Sixers. He has since missed time with reoccurring tendinitis in the knee and underwent his own round of PRP treatment during the most recent offseason. Other players that have reported managing chondromalacia include Kenyon Martin, Jerry Stackhouse, Speedy Claxton, and Jarrett Jack. A majority of those diagnosed with the condition endured reoccurring problems with many eventually opting for some sort of surgical procedure to alleviate the symptoms.

For Bogut, the condition is clearly a significant issue as the associated swelling was so severe he had to have his knee drained. Moreover, the resulting damage is extensive enough that the bony tissue in the area has become inflamed, a common problem associated with the development of arthritis.

It should also be noted that Bogut has dealt with cartilage issues in the past. Prior to the start of the 2012-13 season, Bogut required a microfracture procedure on his previously fractured left ankle. The ankle would be a major problem during his first season in Golden State, costing him 44 games during the regular season and severely limiting him during the postseason.

The PRP injections will help treat the lingering symptoms and create an environment conducive to healing. However time off is still necessary and there’s always the risk of the problem resurfacing when he returns to action. In the meantime, Bogut will let the PRP treatment runs its course and likely begin a rehab protocol designed to correct any underlying issues that could be contributing to the problem. The Warriors have ruled him out indefinitely providing him ample time to recover.

Golden State is good enough to navigate the regular season without Bogut for a substantial period of time but the team knows they need their defensive anchor to contend for a title. The Aussie center has opted to take a proactive approach to improving his ailing knee but faces an uphill battle to return without any lingering issues. Now only time will tell if chondromalacia becomes the latest ailment to derail the career of the former number one overall pick.

Below is a video I did a few years back with the Pulse Network detailing Chase Utley’s bout with chondromalacia.

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