TY - JOUR T1 - The Effectiveness of Quadriceps Strengthening in Chondromalacia Patella Rehabilitation and the Contribution to Clinical Outcomes: A Systematic Review TT - Kondromalazi Patella Rehabilitasyonunda Kuadriseps Kas Güçlendirme Egzersizlerinin Etkinliği ve Klinik Sonuçlara Katkısı: Sistematik Bir İnceleme AU - Özduran, Erkan PY - 2026 DA - June Y2 - 2026 DO - 10.7197/cmj.1897775 JF - Cumhuriyet Medical Journal JO - CMJ PB - Sivas Cumhuriyet University WT - DergiPark SN - 1305-0028 SP - 35 EP - 40 VL - 48 IS - 2 LA - en AB - Chondromalacia Patella (CMP), one of the most common knee joint pathologies, is a progressive condition characterized by structural deterioration in the retropatellar cartilage and causing anterior knee pain. Although strengthening the quadriceps muscle group is considered a fundamental component of treatment, the effectiveness of different exercise protocols continues to be debated. The aim of this study is to evaluate the effectiveness of quadriceps strengthening exercises in CMP rehabilitation and to comparatively examine the clinical superiority of these methods over holistic biomechanical approaches with stabilization of adjacent joints such as the hip, in light of the literature. This study was designed as a systematic literature review. The PubMed, Web of Science, and Google Scholar databases were used to access academic publications published between January 1, 2010, and January 1, 2026; the databases were searched using the keywords "chondromalacia patella", "chondromalacia patella exercises", "chondromalacia patella rehabilitation", and "chondromalacia patella treatment". The review process was conducted according to the PRISMA guidelines, and 7 articles directly related to the topic were included in the final evaluation in line with the determined PICO criteria. The studies reviewed showed that quadriceps muscle strength loss is directly related to CMP and that both isometric and isotonic exercises provide significant improvement in pain and functional scores. However, some studies have shown that strengthening the posterolateral hip muscles provides superior and lasting results in earlier pain control compared to quadriceps exercises. In addition, holistic approaches such as spinal manipulation were found to be effective in improving knee function by correcting lumbar spinal alignment and restoring the biomechanical balance of the lower extremity kinetic chain. While exercises aimed at strengthening the quadriceps muscle are of fundamental importance in CMP rehabilitation, going beyond local approaches is necessary for the success of the treatment. In order to optimize clinical outcomes and accelerate the healing process, hip stabilization with quadriceps exercises is necessary. It is recommended that these be integrated with biomechanical approaches encompassing the entire lower extremity kinetic chain. KW - chondromalacia patella KW - quadriceps exercises KW - anterior knee pain KW - hip strengthening KW - rehabilitation N2 - Diz ekleminin en yaygın patolojilerinden biri olan Kondromalazi Patella (KMP), retropatellar kıkırdaktaki yapısal bozulmalarla seyreden ve diz önü ağrısına neden olan progresif bir tablodur. Tedavide kuadriseps kas grubunun kuvvetlendirilmesi temel yaklaşım olarak kabul edilse de farklı egzersiz protokollerinin etkinliği tartışılmaya devam etmektedir. Bu çalışmanın amacı, KMP rehabilitasyonunda kuadriseps güçlendirme egzersizlerinin etkinliğini değerlendirmek ve bu yöntemlerin kalça gibi komşu eklem stabilizasyonu ile bütüncül biyomekanik yaklaşımlar karşısındaki klinik üstünlüğünü literatür verileri ışığında karşılaştırmalı olarak incelemektir. Çalışma, sistematik bir literatür taraması olarak tasarlanmıştır. 01.01.2010 ile 01.01.2026 tarihleri arasında yayımlanmış akademik yayınlara ulaşmak amacıyla PubMed, Web of Science ve Google Scholar veri tabanları; “"kondromalazi patella", "kondromalazi patella egzersizleri", "kondromalazi patella rehabilitasyonu" ve "kondromalazi patella tedavisi" anahtar kelimeleriyle taranmıştır. İnceleme süreci PRISMA kılavuzuna göre yürütülmüş ve belirlenen PICO kriterleri doğrultusunda, konuyla doğrudan ilgili 7 makale nihai değerlendirmeye dahil edilmiştir. İncelenen çalışmalar, kuadriseps kas kuvveti kaybının KMP ile doğrudan ilişkili olduğunu ve hem izometrik hem de izotonik egzersizlerin ağrı ve fonksiyonel skorlarda anlamlı iyileşme sağladığını göstermiştir. Ancak, bazı araştırmalar posterolateral kalça kaslarının güçlendirilmesinin, ağrının daha erken kontrol altına alınmasında kuadriseps egzersizlerine göre daha üstün ve kalıcı sonuçlar verdiğini ortaya koymuştur. Ayrıca, spinal manipülasyon gibi bütüncül yaklaşımların, lomber spinal dizilimi düzelterek alt ekstremite kinetik zinciri üzerindeki biyomekanik dengeyi yeniden tesis ettiği ve bu sayede diz fonksiyonlarını iyileştirmede etkili bir yöntem olduğu saptanmıştır. KMP rehabilitasyonunda kuadriseps kasını güçlendirmeye yönelik egzersizler temel öneme sahip olmakla birlikte, tedavinin başarısı için lokal yaklaşımların ötesine geçilmesi gerekmektedir. Klinik sonuçları optimize etmek ve iyileşme sürecini hızlandırmak amacıyla, kuadriseps egzersizlerinin kalça stabilizasyonu ve tüm alt ekstremite kinetik zincirini kapsayan biyomekanik yaklaşımlarla entegre edilmesi önerilmektedir. CR - 1. Dursun M, Ozsahın M, Altun G. Prevalence of chondromalacia patella according to patella type and patellofemoral geometry: a retrospective study. Sao Paulo Med J. 2022;140(6):755-761. doi:10.1590/1516-3180.2021.0206.R2.10012022 CR - 2. Damgacı L, Özer H, Duran S. 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