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COX-1 is often thought of as the physiologic housekeeper for many activities including vascular homeostasis, maintenance of renal and gastrointestinal blood flow, renal function, intestinal mucosal proliferation, platelet function, and antithrombogenesis

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These typically include ascending or descending stairs, squatting or running that cause (1, 3): Anterior knee pain Gradual onset of vague, non-specific retro patellar or prepatellar pain Retro patellar crepitus, effusion or wasting of quadriceps (4) It is important to remember that chondromalacia patella rarely occurs by itself and sits along a spectrum of other tendon and soft tissue conditions that cause patellofemoral pain syndrome (PFPS) or runners knee (5)