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Statement of Principles

Chondromalacia patella — DVA SoP factors

Every factor in the Repatriation Medical Authority Statements of Principles for Chondromalacia patella. DVA can only accept a claim for Chondromalacia patella if at least one of these factors is met and connected to your service. Reasonable Hypothesis (RH) applies to operational service; Balance of Probabilities (BoP) applies to peacetime service.

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Source: Repatriation Medical Authority Statements of Principles as held by the Veterans Health Centre. SoPs are amended and replaced regularly; always confirm the current instrument at rma.gov.au before relying on it.

Chondromalacia patella

RH No. 1 of 2019 · BoP No. 2 of 201932 factors

Meaning of chondromalacia patella: For the purposes of this Statement of Principles, chondromalacia patella: (a) means softening, fibrillation or erosion of the articular cartilage of the patella associated with recurrent or chronic patellofemoral pain; and (b) excludes osteoarthritis of the patellofemoral joint. (3) While chondromalacia patella attracts ICD-10-AM code M22.4, in applying this Statement of Principles the meaning of chondromalacia patella is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.

Reasonable Hypothesis (RH) — Statement of Principles No. 1 of 2019

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chondromalacia patella or death from chondromalacia patella with the circumstances of a person's relevant service:

  1. (1)
    having direct trauma to the patella of the affected knee within the three months before the clinical onset of chondromalacia patella;

    Note: direct trauma to the patella is defined in the Schedule 1 - Dictionary.

  2. (2)
    having patellar dislocation of the affected knee within the three months before the clinical onset of chondromalacia patella;
  3. (3)
    having an injury to the affected knee resulting in acute meniscal or ligamentous tear of the knee or permanent ligamentous instability, within the six months before the clinical onset of chondromalacia patella;
  4. (4)
    having acquired abnormal tracking of the patella of the affected knee for at least the three months before the clinical onset of chondromalacia patella;

    Note: abnormal tracking of the patella is defined in the Schedule 1 - Dictionary.

  5. (5)
    running or jogging an average of at least 30 kilometres per week for at least the four weeks before the clinical onset of chondromalacia patella;
  6. (6)
    undertaking weight bearing exercise involving forceful loading of the affected patellofemoral joint, at a minimum intensity of five METs for at least four hours per week, for at least the four weeks before the clinical onset of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  7. (7)
    increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical onset of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  8. (8)
    being obese at the time of the clinical onset of chondromalacia patella;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  9. (9)
    having direct trauma to the patella of the affected knee within the three months before the clinical worsening of chondromalacia patella;

    Note: direct trauma to the patella is defined in the Schedule 1 - Dictionary.

  10. (10)
    having patellar dislocation of the affected knee within the three months before the clinical worsening of chondromalacia patella;
  11. (11)
    having an injury to the affected knee resulting in acute meniscal or ligamentous tear of the knee or permanent ligamentous instability, within the six months before the clinical worsening of chondromalacia patella;
  12. (12)
    having acquired abnormal tracking of the patella of the affected knee for at least the three months before the clinical worsening of chondromalacia patella;

    Note: abnormal tracking of the patella is defined in the Schedule 1 - Dictionary.

  13. (13)
    running or jogging an average of at least 30 kilometres per week for at least the four weeks before the clinical worsening of chondromalacia patella;
  14. (14)
    undertaking weight bearing exercise involving forceful loading of the affected patellofemoral joint, at a minimum intensity of five METs for at least four hours per week, for at least the four weeks before the clinical worsening of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  15. (15)
    increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least two hours per day, for at least the seven days before the clinical worsening of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  16. (16)
    being obese at the time of the clinical worsening of chondromalacia patella;

    Note: being obese is defined in the Schedule 1 - Dictionary.

  17. (17)
    inability to obtain appropriate clinical management for chondromalacia patella;

Aggravation-only factors: the factors in subsections 9(9) to 9(17) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

Balance of Probabilities (BoP) — Statement of Principles No. 2 of 2019

15 factors

At least one of the following factors must exist before it can be said that, on the balance of probabilities, chondromalacia patella or death from chondromalacia patella is connected with the circumstances of a person's relevant service:

  1. (1)
    having direct trauma to the patella of the affected knee within the three months before the clinical onset of chondromalacia patella;

    Note: direct trauma to the patella is defined in the Schedule 1 - Dictionary.

  2. (2)
    having patellar dislocation of the affected knee within the three months before the clinical onset of chondromalacia patella;
  3. (3)
    having an injury to the affected knee resulting in acute meniscal or ligamentous tear of the knee or permanent ligamentous instability, within the six months before the clinical onset of chondromalacia patella;
  4. (4)
    having acquired abnormal tracking of the patella of the affected knee for at least the three months before the clinical onset of chondromalacia patella;

    Note: abnormal tracking of the patella is defined in the Schedule 1 - Dictionary.

  5. (5)
    running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical onset of chondromalacia patella;
  6. (6)
    undertaking weight bearing exercise involving forceful loading of the affected patellofemoral joint, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical onset of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  7. (7)
    increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical onset of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  8. (8)
    having direct trauma to the patella of the affected knee within the three months before the clinical worsening of chondromalacia patella;

    Note: direct trauma to the patella is defined in the Schedule 1 - Dictionary.

  9. (9)
    having patellar dislocation of the affected knee within the three months before the clinical worsening of chondromalacia patella;
  10. (10)
    having an injury to the affected knee resulting in acute meniscal or ligamentous tear of the knee or permanent ligamentous instability, within the six months before the clinical worsening of chondromalacia patella;
  11. (11)
    having acquired abnormal tracking of the patella of the affected knee for at least the three months before the clinical worsening of chondromalacia patella;

    Note: abnormal tracking of the patella is defined in the Schedule 1 - Dictionary.

  12. (12)
    running or jogging an average of at least 60 kilometres per week for at least the four weeks before the clinical worsening of chondromalacia patella;
  13. (13)
    undertaking weight bearing exercise involving forceful loading of the affected patellofemoral joint, at a minimum intensity of five METs for at least six hours per week, for at least the four weeks before the clinical worsening of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  14. (14)
    increasing the frequency, duration or intensity of weight bearing activity involving the affected knee by at least 100 percent, to a minimum intensity of five METs for at least four hours per day, for at least the seven days before the clinical worsening of chondromalacia patella;

    Note: MET is defined in the Schedule 1 - Dictionary.

  15. (15)
    inability to obtain appropriate clinical management for chondromalacia patella;

Aggravation-only factors: the factors in subsections 9(8) to 9(15) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.

A VHC Diagnostic Assessment addresses each of these factors one by one against your service record and clinical history. See how a VHC DVA claim works, see all fees ($600 + GST per stage) or book an appointment.

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Dr Perkins has spent more than thirteen years working exclusively with current and former ADF members — treating their conditions, writing their reports and navigating the DVA system alongside them. With over 100,000 claims submitted and 2,000 Permanent Impairment Assessments completed, he has seen precisely what separates an accepted claim from a rejected one at every level, from initial liability to the Veterans' Review Board.

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