Patellofemoral arthrosis of the knee joint

Patellofemoral arthrosis of the knee

Patellofemoral arthrosis of the knee joint

Patellofemoral arthrosis of the knee

This concept, like patellofemoral arthrosis of the knee joint or any other joint, is absent in the international classification of medical diseases. There is a completely identical disease, with exactly the same characteristics and symptoms, which is absolutely amenable to the same methods of treatment and medicines, only otherwise called "patellofemoral knee joint syndrome".

The concept of "patellofemoral arthrosis" is quite often, but only in specific medical literature of both domestic and foreign authors.

Patellofemoral arthrosis of the knee joint

Pain in the knee joint occurs most often as a result of abnormalities in functioning, as well as in various morphological changes.

Patellofemoral syndrome( as mentioned above, in the literature - arthrosis) occurs as a result of wear of the patellofemoral joint formed by the joint surface and the femur. Inflammation occurs in the groove under the patella( the patella is called the patella).

The structure of the knee joint and the focus of pain under the patella

The structure of the knee joint and the focus of pain under the patella

This pain syndrome is characterized by the development of the initial stage of chondromalation of the patella, and the morphological changes remain unproven.

Chondromalacia is a patellar disease caused by the destruction of the cartilage of the joint. Destruction in this case can be from minor softening and ending with serious defects that destroy cartilage, reaching the bone itself.

From here, chondromalacia develops in the knee joint due to increased friction during movement about the knee joint of the femur.

Patellofemoral knee joint syndrome also requires a certain course of treatment, as well as examination and observation of the doctor, so as not to miss the development of a more serious disease - arthrosis of the joint.

The appearance of patellormoral knee joint syndrome is usually due to excessive stress on some part of the body, and may also be the result of repeated damage to a site caused by intensive training of athletes.

Common symptoms of the patellormoral syndrome

Patellormoral syndrome characterized by the following symptoms:

  • with movements in the knee joint there is a certain discomfort, some limited movement with internal pain;
  • pains are significantly strengthened at certain positions of the leg, especially when sitting, when the leg is bent in the knee at different angles, the pain under the cup is manifested in varying degrees;
  • pains in the patella( kneecap) are amplified when additional stress occurs( jumping, squatting, climbing up stairs, etc.).

Treatment of patellofemoral knee joint syndrome

Patellofemoral arthrosis of the knee joint is diagnosed quite simply, and neither laboratory tests nor hardware diagnostics are needed. It is enough to examine the patient and the place, causing pain, carefully touch and on the behavior of the joint to make a diagnosis.

The patient lies on his back and completely relaxes the knee joints, and the doctor performs palpation: the patella is shifted alternately one way and the other, and the palpation under the edge of the cup from the outer and inner sides is performed, determining painful points.

With patellofemoral syndrome, pain will also occur with contraction of the hip muscles if the patella is kept from moving upwards.

Diagnostic inspection

Diagnostic inspection

Therapy and prevention in the occurrence of patellofemoral knee joint syndrome

This type of disease does not require special and multi-stage treatments, and expensive and rare medications are also not needed. But certain measures of therapy for the patellofemoral knee joint syndrome are still prescribed, it is:

  • appointment to the patient rest;
  • changing the regime of physical activities and training;
  • recommendations for ways to relieve pain, including drugs and procedures;
  • selection of the necessary means of limiting movement of the knee joint.

So, to begin treatment, after examination by a specialist, a patient with a patellofemoral knee joint syndrome is uniquely assigned a break in sports, as well as a general rest, in which any possible physical exertion( with which he encounters in everyday life and at work) should be minimized,.

Further special means are prescribed that limit or soften any movements associated with the affected knee joint. It can be a special soft bandage that is worn on the knee joint.

Bandage for the knee joint

Knee joint bandage

To ease and relieve pain in patellofemoral arthrosis of the knee joint, non-steroidal anti-inflammatory drugs may be prescribed anesthetic drugs( such as aspirin, diclofenac sodium, and others).

Non-steroidal anti-inflammatory drugs are produced in the form of tablets( aspirin, in addition to the usual form of the tablet, happens in effervescent form), ointments, gels, rubs, injections.

Like any kind of medication, non-steroidal anti-inflammatory drugs can cause side effects( headache, nausea, abdominal pain, dizziness, rash), and it depends solely on the individual tolerance of the drug to the body.

It happens that it is enough to apply compresses, for example, ice, to alleviate the pain.

When very severe pain occurs, it is necessary to remove it with the help of special injections( most often it is a mixture: anesthetic and glucocorticosteroids).These injections are injected clearly into the sore point.

Injections to the knee joint

As a rule, the patellofemoral knee joint syndrome passes fairly quickly without complications. But if the procedure of recovery is delayed, then go on to more serious methods of examination, because it may not just be an independent disease, but an accompanying manifestation of a more serious pathology, for example, valgus deformity of the knee joint, knee joint instability, arthrosis of the knee joint.

Patellofemoral syndrome as a manifestation of arthrosis of the knee joint

Arthrosis of the knee joint is a disease that is peculiar to the elderly and requires much more serious and prolonged treatment than the patellofemoral syndrome.

In the treatment of arthrosis, a complex of drugs that improve blood microcirculation, metabolism, restore blood flow, slow down the degeneration of cartilage is first prescribed.

The next step is the appointment of physiotherapy procedures. These include: electrophoresis, ultrasound radiation, radon baths and turpentine baths, as well as effective mud treatment.

Treatment for arthrosis of the knee joint is prescribed only by a doctor. Based on the results of the examination, X-ray examination and laboratory tests, the doctor will prescribe a set of medicines and procedures, and possibly a surgical intervention( for example, inserting plates or grafts, installing an artificial joint), all depends on the degree of development of the disease.

Implant of the knee joint - the result of late treatment of arthrosis

Knee joint implant - the result of late treatment of arthrosis

Prophylaxis and home methods of treatment of patellofemoral and arthrosis of knee joint

The best methods for preventing the development of arthrosis and for its treatment, as well as for treating at home conditions patellofemoral knee joint syndrome are:

  • baths:with sea salt, with dry mustard;
  • tinctures and spices: vodka infusion with chamomile, sweet clover, flax seeds( the infusion is simultaneously taken in and used as a grind);
  • broths of herbs( elder, chamomile, hawthorn, horse chestnut, celandine, horsetail, burdock, buckthorn, arnica, dill);
  • is a balanced diet that includes the following foods in the daily diet: vegetables( especially beetroot, pumpkin, zucchini), any greens, fruits( prunes are especially useful), bread( coarse varieties), dairy products, cereals.
The best prevention of any disease

The best prevention of any disease

When arthrosis is not recommended to tolerate excessive intake of salt and sugar.

And most importantly - with the slightest symptoms of the disease, the appearance of painful points under the patella, one should not neglect the approach to the doctor. Any disease, if it is timely and correctly diagnosed, is treatable.

Video - Patellofemoral arthrosis of knee joint

med-shkola.ru

Features of arthrosis of patellofemoral joint


The term "patellofemoral arthrosis" is used only by specialists in arthrology, traumatology. In the international classification of such a disease does not exist. The correct name is the patellofemoral syndrome of the knee joint.

This does not affect the attitude towards diagnosis and treatment. Medical statistics show that up to 15% of patients with complaints of knee pain are treated with manifestations of changes in patellofemoral articulation. Participation of this knee joint zone in ¼ cases of secondary lesion with various somatic diseases( rheumatoid arthritis, osteochondrosis of the lumbosacral spine, arthritis of the femoral joint) is proved.

More often changes are found in sportsmen, people of advanced age.

Where is this joint, features of the Anatomy

"Patella" - this is the Latin name of the patella. The patellofemoral joint forms the upper edge of the patella and the joint surface of the femur. Maximum contact with the trochlear thigh groove occurs with the knee flexed.

The main task of the patella is to strengthen the muscle of the quadriceps, which extends the knee. Calculations and the study of dynamics in computed tomography show an increase in strength due to the patella by 50%.Its usual position when unbending is a small detour down and out.

Important in the instability of patellofemoral arthrosis is given to the types of patella configuration. There are 3 variants:

  • type 1 - the patella is located exactly in the center;
  • type 2 - most of the area shifts to the outside;
  • type 3 - offset to the outside is very significant.

Types 2, 3 are one of the contributing factors to the causes of arthrosis in the articulation.

Smooth sliding is provided by the contact surfaces, the structure of the cartilaginous tissue. The necessary correct retention of the patella depends on the condition of the ligamentous apparatus. The medial patellofemoral ligament serves as a stabilizer and does not allow the patella to deviate laterally. Additional fixative support is provided by the patellar-meniscus ligament and the tendon of the quadriceps.

There are superficial and deep ligaments from the lateral( external) side, not allowing the patella to swerve inwards.

Displacement from the normal axis of motion occurs with dislocation, rupture of ligaments, other traumatic effects.

Causes of the disease

Also you can read: Ointments for arthrosis of the knee joint

Patellofemoral arthrosis is recognized by many authors as the initial manifestation of arthrosis of the knee joint of the first degree, when there are still no pronounced changes in the x-ray, symptoms of inflammation. Therefore, the general classification of arthrosis is not applicable to the disease.

Patologic patellar bias is more often caused by chronic long-term illnesses than by trauma. Excess weight is considered one of the main factors of instability of the joint.

The mechanical effect of trauma depends on the degree of flexion of the joint. Falling on the bent knee usually contributes to blunt damage to the patella cartilage, a pathological shift to the side, damage to the femoral surface of the joint and the tibia( turning outwards).

The mechanism of a fall or injury is taken into account in the diagnosis. Trauma is accompanied by subluxation or dislocation of the patella.

Thinning of the articular cartilage is called chondromalacia. It is this process that leads to pain syndrome, but there is also an asymptomatic course.

Symptoms of

Clinical manifestations such as walking pain, limping, swelling and "clicks" in the knee joints are common, but are not specific symptoms for changes in the patellofemoral joint.

In contrast, the physician draws attention to the following patient complaints:

  • pain limited only to the front of the knee;
  • abruptly increase or appear in the squat position, as well as when lifting from a chair after a long sitting position;
  • soreness is felt when climbing the stairs.
Pain in the knee joint
The patient independently determines the most painful area

Clinical course

It is accepted to distinguish 3 degrees of the disease:

  • the first - the symptoms are not permanent, appear after a long walk, with the strain of the knee joints;
  • the second - is distinguished by the appearance of complaints on acute and prolonged pains on the front surface of the knee after heavy loads, sports training, carrying heavy loads, descending and climbing the stairs, disappear on their own during rest;
  • is the third - characterized by initial dystrophic changes in articular surfaces, pain syndrome does not disappear, treatment is required.

As the disease is diagnosed

Since the radiographically patellofemoral arthrosis of the knee is very poorly expressed, the physician should be guided by the collected history of complaints, the mechanism of overload or trauma, and examination of the knee.

Differentiation of the disease is necessary with reflex pain for arthrosoarthritis of the hip joint, meniscus pathology, rheumatoid polyarthritis, change of cruciate ligaments.

Attention of the traumatologist when examining the patient

Attentive attitude of the traumatologist to the patient allows to establish the correct diagnosis.

  1. When examining the gait, there is an excessive displacement of the tibia, a pathological turn of the patella.
  2. Measurement of muscles around the knee joint suggests atrophic consequences of vascular diseases.
  3. Determine the angle of deviation from the main axis of the thigh with full knee extension. The pathological value is more than 200 degrees.
  4. In the position of the patient sitting and moving in the knee, the doctor observes the excessive movement of the patella from the outside with the "jump" upwards. This indicates a disbalance between the inner and lateral retention ligaments.
  5. The ability of the maximal flexion and extension of the knee is checked. Normally a person can bend his knees so that heels reach his buttocks.
  6. Strengthening of soreness by pressing on the patella and simultaneous extension of the joint is determined.
  7. The strength of the medial and lateral ligaments is checked with active extension in conditions of forced retention of the nascent calyx.
The doctor examines the patient
When palpation of the joint, the doctor pays attention to the presence of effusion, tenderness of soft tissues in the patellar tendon region,

ligaments. Additional hardware diagnostic methods are used in cases of dubious diagnosis. Are applied:

  • a roentgenography of a knee joint;
  • magnetic resonance imaging;
  • computed tomography.

Therapeutic tactics

There is no standard treatment for patellofemoral syndrome. In the initial stage, it is enough for a while to stop reinforced athletic training, ease the load on the joint.

Special patches or tight bandages are used to support the patella.

If you have excess weight, it is recommended to unload the joints due to weight loss of the patient.

As an analgesic therapy,

  • is recommended for non-steroidal anti-inflammatory drugs;
  • analgesics;
  • compresses with ice.
Puncture of knee joint
If a connection with arthritis or arthrosis of the knee joint is detected, the administration of anti-inflammatory hormonal agents to the cavity of the joint capsule

is performed. Constant pains indicate an arthritis clinic. In the presence of confirmed destruction, chondroprotectors are used.

Good results are obtained by conducting a course of physiotherapy( ultrasound, galvanization), balneological methods( mud, turpentine and radon baths).

The prescribed forms of the disease require the use of surgical treatment. Most often, an arthroscopic operation is used to remove pathologically altered tissues.

Home Treatment Methods

Home can be prepared tinctures for grinding and compresses, apply baths.
Compresses with tincture of chamomile, flax seeds, decoctions of herbs( horse chestnut, chamomile, elder, sweet clover, burdock, arnica, dill) are a productive way.

What to do to prevent

To prevent patellofemoral syndrome, you need:

  • to control your weight;
  • not to over-eat, eat vegetables, fruits, protein foods daily;
  • pay attention to leg muscle training;
  • sports load to start with a warm-up of muscles;
  • buy shoes with a good shock-absorbing stock of the sole;
  • does not postpone the wearing of special insoles for flatfoot.

The appearance of pain in the legs when walking on the stairs requires consultation of a traumatologist and strengthening treatment. The condition should not be started before severe arthrosis of the knees, a sharp decrease in motor activity.

MoyaSpina.ru

Causes of development, manifestations and therapy of the patellofemoral pain syndrome

Pain in the knee joint may not always be a sign of arthritis or other serious illness. In some cases, it can be a patellofemoral pain syndrome and this diagnosis can often be heard from an orthopedist, especially when the patient complains of knee pain.

Symptoms of

Despite the fact that in medicine this term can be found quite often, it was not officially recognized and is not a separate type of arthrosis. And since the main symptom of this pathology is pain, the more common name of this arthrosis will sound just like a pain syndrome.

Pain occurs in different situations. This can be a descent or climbing the stairs, a long squatting or pose, when the knees are for a certain time only in a bent position. Also when the knee is working, attention is attracted by crackling or crunching.

As for the reasons, there is no unambiguous opinion. However, most experts believe that it is all the fault of the damage to the cartilaginous tissue, which is located in the patella area.

Causes of

Over time, the cartilaginous tissue begins to gradually wear out and thin, which in turn deprives the knee of depreciation, which is very important in both walking and running. The disappearance of the cartilaginous layer leads to the fact that the bones begin to rub against each other. Most often, this condition is typical for those people who have increased stress on the knee for a long time. And skiers, jumpers, and elderly people suffer more than others. Also, the development of the patellofemoral pain syndrome of the knee joints is facilitated by trauma, in which there was a violation of the joint structure due to a significant displacement of the bones.

Unlike all other knee diseases, this pathology is quite easy to diagnose. To do this, you may need to manually palpate, while the doctor determines the place, when pressed, which pain is increased several times. However, in order to rule out the possibility of developing other, more serious pathologies, research methods such as MRI, CT or X-ray can be prescribed. All of them allow to get an accurate clinical picture and without effort will help to diagnose, prescribe treatment and preventive measures to prevent the further development of pathology.

Conservative treatment

Patellofemoral pain syndrome is a pathology that does not require any expensive or prolonged treatment. The most important thing here is to do regular compresses on your knee and give your feet peace, especially with regard to the affected joint. Such treatment perfectly helps at the very beginning of the disease, but few of the patients turn to the doctor at the first stage of pathology development. Therefore, if this syndrome was diagnosed, then the treatment should be started immediately.

In some cases, therapy may be used that is similar to treatment for arthrosis.

  1. Use of pain medication.
  2. Use of orthopedic products that help reduce the strain on the affected joint.
  3. Application of bandages from elastic bandage.

Perform exercises that will help strengthen the muscles. Exercises in patellofemoral pain syndrome should be done regularly and under the supervision of an experienced specialist. This can be squatting without detaching the foot from the floor, swinging, flexing and unbending the knee joints in the position lying on the back, and some other exercises.

If the disease has gone too far, then surgical methods can be used, for example, lateral release. At the same time, the lateral ligament is dissected and the patella returns to its place. The second method of surgical treatment is arthroscopy. This removes the damaged cartilage.

Prevention

To avoid this unpleasant disease, you need to regularly perform charging, follow the weight, use only high-quality shoes. When practicing sports, use quality sneakers that are not worn in everyday life. And, of course, with the first signs, you should always consult a doctor to prevent further development.

NashyNogi.ru

Patellofemoral arthrosis: diagnosis and therapeutic procedures

There is no such diagnosis as patellofemoral arthrosis in the international classification of diseases. There is a patellofemoral syndrome. However, the term is often used in domestic and foreign specialist literature. That is, patellofemoral arthrosis is the same as patellofemoral syndrome.

Clinical picture of

Osteoarthritis of the knee joint often begins with a patellofemoral syndrome. The same syndrome is observed if a certain part of the body is subjected to excessive load or there are repeated injuries associated with the performance of physical exercises.

The main symptoms are as follows:

  • stiffness in the kneecap( on the inner or front side);
  • pain on the front side of the knee joint, increasing with additional load( climbing or descending the stairs, running, squats, jumps, etc.);
  • increased pain in sitting position with bent legs.

Patellofemoral arthrosis: diagnosis

Pain syndrome develops between the surfaces of the patella joint and the adjacent part of the thigh. At the same time, there are no inflammatory phenomena in this area.

Patellofemoral syndrome in initially healthy people is diagnosed clinically. Visual and laboratory studies, as a rule, are not required. The patient is offered to lie on his back and relax the knee joints. With one hand, the doctor moves the patella inward, and with the other hand, from the inside, palpates under the edge of the patella. Thus there are painful points. Then the procedure is repeated, shifting the patella outward and palpating under its outer edge.

Pain may also appear when the hamstrings contract with the retention of the patella from upward movement.

Therapeutic procedures for patellofemoral syndrome

This pathology does not require special treatment. Nevertheless, if the pain interferes with the movement, it must be fought with. In the therapy of patellofemoral syndrome, the following procedures take place:

1) Decreased physical exertion. The patient should choose a level of activity that does not provoke pain.2) When performing physical exercises, you can use a soft bandage on the knee joint area, which will fix the patella.3) The pain after a long load on the knee facilitates the ice.4) In acute pain( when the patellofemoral syndrome is a symptom of arthrosis of the knee joint), an accurate introduction of a mixture of anesthetic and glucocorticosteroids into painful points is practiced. This technique will help relieve pain in this area and avoid further use of anti-inflammatory drugs. The injection is made under pressure on the fibrous tissue. This helps to secure the capsule of the joint at the edge of the patella. When inserting the needle, you must not allow the entry into the joint cavity( such an injection would be useless).

As already mentioned, the patellofemoral syndrome can accompany more serious pathologies. Such as valgus or varus deformity of the knee joint, as well as instability of the patella. If there are degenerative-dystrophic changes in the knee joint, then methods of treating arthrosis of the knee joint are used.

If the patellofemoral syndrome is not a symptom of other diseases, it can pass on its own while observing the basic procedures. If the pain does not last a long time, chondroprotectors are prescribed intra-articularly. Often this syndrome is "capricious": a person feels pain, then does not feel it. But to ignore the appearance of painful points near the patella is not worth it.

opozvonochnike.ru

Patellofemoral arthrosis: diagnosis and therapeutic procedures |Diseases of the spine

There is no such diagnosis as patellofemoral arthrosis in the international classification of diseases. There is a patellofemoral syndrome. However, the term is often used in domestic and foreign specialist literature. That is, patellofemoral arthrosis is the same as the patellofemoral syndrome.

Clinical picture of

Osteoarthritis of the knee joint often begins with a patellofemoral syndrome. The same syndrome is observed if a certain part of the body is subjected to excessive load or there are repeated injuries associated with the performance of physical exercises.

The main symptoms are as follows:

  • stiffness in the kneecap( on the inner or front side);
  • pain on the front side of the knee joint, increasing with additional load( climbing or descending the stairs, running, squats, jumps, etc.);
  • increased pain in sitting position with bent legs.

Patellofemoral arthrosis: diagnosis

Pain syndrome develops between the surfaces of the patella joint and the adjacent part of the thigh. At the same time, there are no inflammatory phenomena in this area.

Patellofemoral syndrome in initially healthy people is diagnosed clinically. Visual and laboratory studies, as a rule, are not required. The patient is offered to lie on his back and relax the knee joints. With one hand, the doctor moves the patella inward, and with the other hand, from the inside, palpates under the edge of the patella. Thus there are painful points. Then the procedure is repeated, shifting the patella outward and palpating under its outer edge.

Pain may also appear when the hamstrings contract with the retention of the patella from upward movement.

Therapeutic procedures for patellofemoral syndrome

This pathology does not require special treatment. Nevertheless, if the pain interferes with the movement, it must be fought with. In the therapy of patellofemoral syndrome, the following procedures take place:

1) Decreased physical exertion. The patient should choose a level of activity that does not provoke pain.2) When performing physical exercises, you can use a soft bandage on the knee joint area, which will fix the patella.3) The pain after a long load on the knee facilitates the ice.4) In acute pain( when the patellofemoral syndrome is a symptom of arthrosis of the knee joint), an accurate introduction of a mixture of anesthetic and glucocorticosteroids into painful points is practiced. This technique will help relieve pain in this area and avoid further use of anti-inflammatory drugs. The injection is made under pressure on the fibrous tissue. This helps to secure the capsule of the joint at the edge of the patella. When inserting the needle, you must not allow the entry into the joint cavity( such an injection would be useless).

As already mentioned, the patellofemoral syndrome can accompany more serious pathologies. Such as valgus or varus deformity of the knee joint, as well as instability of the patella. If there are degenerative-dystrophic changes in the knee joint, then methods of treating arthrosis of the knee joint are used.

If the patellofemoral syndrome is not a symptom of other diseases, it can pass on its own while following the basic procedures. If the pain does not last a long time, chondroprotectors are prescribed intra-articularly. Often this syndrome is "capricious": a person feels pain, then does not feel it. But to ignore the appearance of painful points near the patella is not worth it.

moypozvonochnik.ru

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