Labels:text | screenshot OCR: Resident and Staff Physician Patient Education Chart Chondromalacia Patellae Cartilage joint surface of the patella becomes roughened and worn. This causes an aching under or around the kneecap, especially when bending the knee. Weakness in the vastus medialis muscle allows the vastus lateralis muscle and the iliotibial tract to pull the patella out of its groove when the knee bends. Reprinted with permission from Resident and Staff Physician (c) 1991-92, 1993 by Romaine Pierson Publishers, Inc.