I had arthroscopic surgery 1 1/2 years ago on my right knee. Since the operation, I have maintained a steady exercise program of biking, swimming and weights without going to extremes. However, none of this has helped the pain I have in the front of my knee when going up and down stairs. Is there something I should be aware of to help eliminate or reduce my pain?

It sounds like you have chondromalacia of the patella, or kneecap. Chondromalacia is a softening of the cartilage under the kneecap. The cartilage becomes soft and eventually wears down from excessive frictional forces. Injuries such as a direct impact to the front of the knee can damage the underlying cartilage of the patella. Since this cartilage has a limited blood supply, the healing capacity is also limited. Traumatic impact is just one scenario in which the cartilage will soften and eventually wear down. The more common source of chondromalacia of the patella is instability and bad tracking of the patella. If the patella moves with a shifting pattern rather than a smooth glide, the cartilage will soften. This can bring on pain and giving way, especially with stair-climbing. I would advise you to review your exercise activities and eliminate any in which you perform repeated deep squatting and excessive pivoting. Raising your bicycle seat can help reduce some stress on the patella while cycling. Exercise that targets the quadriceps muscle of the thigh is important to
maintain good alignment and tracking for the patella as the knee moves through a range of motion. You should consider trying a knee brace that has a doughnut-hole design in the front of the brace for the patella. The brace will help you stabilize the patella during your exercise. If activity modification, exercise and bracing fail to ease your symptoms, there are surgical procedures that can stabilize and realign the patella to reduce the stress on the cartilage surfaces.