A study of the literature on chondromalacia of the patella shows that its etiology is ill understood. Most writers have been willing to accept injury as its cause without much question. INCIDENCE OF CHONDROMALACIA OF THE PATELLA OBSERVED AT MENISCECTOMY Articular cartilage of patella Age in years Number of cases Normal Abnormal 12-19 24 12 12 in patients with advanced patellar changes or with generalised osteoarthritis of the knee; 752 THE JOURNAL OF BONE AND JOINT SURGERY THE ETIOLOGY OF CHONDROMALACIA PATELLAE

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The height of the ridge was determined by projecting the surface of the shaft through it, and then measuring the ridge height above this line in millimetres. Some of the ridges were THE JOURNAL OF BONE AND JOINT SURGERY children, however, bulging of either the epiphysial bone or the cartilage, or both, beyond the surface of the shaft occurs before fusion of the epiphysis to the shaft takes place (Fig. 6). VOL. 46B, NO. 2, MAY 1964 A R. E. OUTERBRIDGE THE JOURNAL OF BONE AND JOINT SURGERY Also, in children, the lateral epiphysial condyle, unlike the medial, tapers down to blend smoothly with the shaft (Fig. 7). It seems, therefore, that the formation of the ridge, and its effect on the etiology of chondromalacia of the patella, may begin at an early age. 4 19 M 5 16 M