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The initial pathological change in CMP is that the cartilage becomes dull or even slightly yellowish-white, and turns soft, swollen and edema in the early stage [4, 5], Characteristically, the lesion is usually in the middle of the medial patellar facet, or just distal to that point, and is about half an inch or more in diameter [5], and followed by the fibrillation, fissure, fragmentation, or erosion of the cartilage at the advanced stage [5–7]