Statement of Principles concerning chondromalacia patellae No. 34 of 2001

Statement of Principles

concerning

CHONDROMALACIA PATELLAE

Instrument No. 34 of 2001 as amended

made under section 196B(3) of the

Veterans’ Entitlements Act 1986

This compilation was prepared on 28 July 2005
taking into account Amendment of Statement of Principles concerning CHONDROMALACIA PATELLAE (Instrument No. 27 of 2005)

Prepared by the Repatriation Medical Authority Secretariat, Brisbane

Revocation and Determination

of

Statement of Principles

concerning

CHONDROMALACIA PATELLAE

ICD 10-AM-CODE: M22.4

Veterans’ Entitlements Act 1986

1. The Repatriation Medical Authority under subsection 196B(3) of the Veterans’ Entitlements Act 1986 (the Act):

(a) revokes Instrument No.321 of 1995; and

(b) determines in its place the following Statement of Principles.

Kind of injury, disease or death

2. (a) This Statement of Principles is about chondromalacia patellae and death from chondromalacia patellae.

(b)               For the purposes of this Statement of Principles, “chondromalacia patellae” means softening, fibrillation or erosion of the articular cartilage of the patella associated with recurrent or chronic patellofemoral pain, attracting ICD-10-AM code M22.4, but excluding osteoarthrosis of the patellofemoral joint.

Basis for determining the factors

3. On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that chondromalacia patellae and death from chondromalacia patellae can be related to relevant service rendered by veterans or members of the Forces.

Factors that must be related to service

4. Subject to clause 6, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person.

Factors

5. The factors that must exist before it can be said that, on the balance of probabilities, chondromalacia patellae or death from chondromalacia patellae is connected with the circumstances of a person’s relevant service are:

(a) suffering direct trauma to the patella of the affected knee within the three months immediately before the clinical onset of chondromalacia patellae; or

(b)              suffering an injury to the affected knee resulting in meniscal damage or permanent ligamentous instability within the three months immediately before the clinical onset of chondromalacia patellae; or

(c)               suffering abnormal tracking of the patella of the affected knee at the time of the clinical onset of chondromalacia patellae; or

(d)              suffering direct trauma to the patella of the affected knee within the three months immediately before the clinical worsening of chondromalacia patellae; or

(e)               suffering an injury to the affected knee resulting in meniscal damage or permanent ligamentous instability within the three months immediately before the clinical worsening of chondromalacia patellae; or

(f)                suffering abnormal tracking of the patella of the affected knee at the time of the clinical worsening of chondromalacia patellae; or

(g) inability to obtain appropriate clinical management for chondromalacia patellae.

Factors that apply only to material contribution or aggravation

6. Paragraphs 5(d) to 5(g) apply only to material contribution to, or aggravation of, chondromalacia patellae where the person’s chondromalacia patellae was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e) or 70(5)(d) of the Act refers.

Inclusion of Statements of Principles

7. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.

Other definitions

8. For the purposes of this Statement of Principles:

“abnormal tracking of the patella” means aberrant movement or position of the patella relative to the femoral condyles in the course of knee flexion or extension resulting from one of the following:

(i)                angulation or rotation deformities involving the knee joint; or

(ii)              patella alta (a high riding patella); or

(iii)           lateral angulation of the patellar ligament relative to the line of action of the quadriceps muscles of  20 degrees; or

(iv)            subluxation of the patella;

“death from chondromalacia patellae” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chondromalacia patellae;

“direct trauma to the patella” means a blow to the kneecap causing immediate patellar pain that persists for at least 24 hours unless alleviated by analgesia;

“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;

“relevant service” means:

(a) eligible war service (other than operational service); or

(b) defence service (other than hazardous service);

“terminal event” means the proximate or ultimate cause of death and includes:

(a) pneumonia;

(b)              respiratory failure;

(c)              cardiac arrest;

(d)              circulatory failure; or

(e)              cessation of brain function.”

Application

9. This Instrument applies to all matters to which section 120B of the Act applies.

Notes to Statement of Principles concerning chondromalacia patellae (Instrument No. 34 of 2001)

The Statement of Principles concerning chondromalacia patellae (Instrument No. 34 of 2001) in force under section 196B(3) of the Veterans’ Entitlements Act 1986, as shown in this compilation is amended as indicated in the Tables below.

Table of Instruments

Table of Amendments