Chondromalacia and Bipartite Patella Management in a High School Baseball Catcher: Case Study

Investigate the efficacy of clinical interventions with an adolescent athlete presenting with chondromalacia caused by overuse injury and a medical history of bipartite patella with focus on a phased physical therapy protocol. After diagnosis, the subject was advised to undergo therapeutic rest with an orthosis. After this 2-week period, the subject began a 7.5-week physical therapy protocol. This protocol included equipment such as resistance bands, balance boards, and agility ladders, targeting specific muscle groups, including the quadriceps femoris and hamstring muscles. Patient outcomes included manual muscle testing (MMT), range of motion (ROM), the 11-item numeric rating scale for pain (NRS-11), and additional clinical assessments were also conducted to determine treatment efficacy, including NSAID medication cessation. Return to sport was the primary goal and outcome. Following treatment, the patient’s median MMT scores were 5/5 bilaterally. This was increased (p < 0.05) compared to the 4/5 involved-side MMT scores. Further, involved-side knee flexion improved from 136º to 157º, and was able to reach terminal knee extension. Initially, the subjects’ NRS-11 pain score was a 9/10 and concluded with 0 to 2/10. Notably, the subject’s right-sided antalgic gait was dispelled, and he returned to play. The use of appropriate interventions and physical therapy in an adolescent baseball player diagnosed with chondromalacia and bipartite patella produced notable positive outcomes and successful return to play.