Patellofemoral arthrosis of the knee
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
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 for 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, identifying painful points.
With patellofemoral syndrome, pain will also occur with contraction of the hip muscles if the patella is kept from moving upwards.
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 at home 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.
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 and laboratory tests, the doctor will prescribe a set of medicines and procedures, and possibly, surgical intervention( for example, inserting plates or grafts, installing an artificial joint) is all depends on the degree of the disease.
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
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 knee cap should not be neglected by the doctor. Any disease, if it is timely and correctly diagnosed, is treatable.
Video - Patellofemoral arthrosis of the knee
Detection and treatment of patellofemoral arthrosis of the knee joint
Patellofemoral arthrosis is manifested by pain in the knee joint. When the disease occurs, the cartilage is damaged between the femur and the kneecap. In official medicine( according to the international classification), this condition is not considered an independent form of arthrosis, although the term is often found in medical publications. Correctly, this disease is called patellofemoral syndrome.
Causes and symptoms of
The following factors contribute to the appearance of the patellofemoral syndrome:
- Cartilage can be damaged as a result of both congenital and acquired joint deformities.
- An abnormal development of the knee may be the cause of cartilage change.
- Cartilage deformation can cause systematically repeated overloads.
In the joint, as a result of a decrease in the layer of cartilaginous tissue, there is an increase in the friction of the bones. A consequence of further progression of the syndrome may be arthrosis of the knee joint. The pain that occurs when performing simple movements and limiting the mobility of the knee joint, serves as the main clinical manifestation of the disease. When walking, there is a stiffness on the left and right of the kneecap. The condition of prolonged immobility of the joint causes painful sensations in it, which can be reduced by performing special exercises.
Too much stress on the knee increases pain, rest helps them loosen. Painful sensations arise in such types of movement as jumping, running, squats, climbing or descending stairs. The position of the body, in which the legs are bent under the seat, is also associated with a feeling of severe discomfort.
Diagnosis and prevention of arthrosis
X-ray of a patient with this diagnosis
The disease is diagnosed clinically. The doctor palpates the relaxed joint, displacing the patella, and determines the position of the painful areas. With the reduction of the femoral muscles, if the patella is prevented from moving, pain can also occur. To exclude arthrosis of the knee and other pathologies that may be accompanied by patellofemoral syndrome, the doctor prescribes the examination using computer tomography, radiography or MRI.
With age, the patellofemoral syndrome can occur more often, as the risk of developing the disease increases. To prevent its appearance, you need to control your own weight, moderately train your leg muscles, knead your joints before high loads, wear shoes with good shock absorption properties. In the presence of flat feet should use orthopedic shoes or insoles. A healthy lifestyle and a protein-rich balanced diet will help prevent changes in the tissues of the knee joint. Self-medication is ineffective and fraught with the progression of the disease, so only the doctor can choose the method of treatment and prescribe the procedure.
To detect the disease at an early stage and increase the chances of a cure will help to take a close look at your health. When pain occurs around the patella( patella), immediately consult a doctor. Timely detection and treatment of the patellofemoral syndrome can prevent its overgrowing into arthrosis of the knee joint.
Methods for treating patellofemoral arthrosis
If there are signs of patellofemoral syndrome, the doctor can prescribe to the patient certain restrictions and symptomatic treatment to reduce pain, prevent inflammation and joint deformity:
- A reduction in physical activity is required to the extent that the activity does not cause pain.
- The joint under load should be fixed with a soft bandage supporting the patella.
- Stopping the pain is helped by applying ice to the knee joint.
- For severe pain, treatment with glucocorticosteroid injections and anesthetic medications that can be administered directly to painful sites is possible.
Osteoarthritis, which does not have concomitant diseases, can be passed quickly enough when performing restrictive measures and appointing a doctor.
For long-term pain, treatment with the intra-articular introduction of chondroprotectors can be prescribed. If the syndrome is accompanied by complications and diseases( instability of the patellar patella, various types of deformities), then the necessary medical procedures are performed for their treatment. If there are signs of a degenerative-dystrophic pathology, this means that the syndrome has passed to arthrosis of the knee joint.
The appropriate therapeutic regimen is used according to the doctor's prescription. Patellofemoral arthrosis of the knee( the most loaded) joint can be treated with the use of surgical intervention. The following manipulations are performed:
- When a lateral release is performed, a lateral supporting ligament is dissected, which returns the patella to its natural position.
- For arthroscopy, the damaged cartilage is removed. The operation is performed( using an arthroscope) inside the cavity of the patellofemoral joint. The instrument is inserted into it through the incision and the pathologically altered tissue is removed.
Causes of development, manifestations and therapy of patellofemoral pain syndrome
Pain in the knee joint may not always be a sign of arthritis or other serious disease. 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.
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.
Over time, cartilaginous tissue begins to gradually wear out and thin out, 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 of
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.
- Use of anesthetics.
- Use of orthopedic products that help reduce the strain on the affected joint.
- 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 may 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.
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.
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 patella( on the inner or front side);
- pain on the front side of the knee joint, increasing with additional load( climbing or descending 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 with contraction of the thigh muscles with 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.
Patellofemoral arthrosis of the knee joint is a common diagnosis that traumatologists put to patients with complaints of pain in the knee. The most defenseless before this disease are old men, skiers, athletes. Patellofemoral arthrosis affects people after knee joint injuries, especially with the displacement of bone fragments associated with joint deformation.
Patellofemoral arthrosis: symptoms
Symptomatic picture Patellofemoral arthrosis begins with pain. At first, she worries with a long squatting, a long limb in a bent state, downhill climbing staircases.
Pain manifests the destruction of the cartilage under the calyx, which worsens the cushioning ability of the joint structure. With deterioration in depreciation, cartilage layers begin to break down, because they suffer a heavy load. At this stage, you can hear the joint work when walking, crunching, crackling. There is a feeling of friction, which increases with fiz.loads.
Medication and surgical treatment of patellofemoral arthrosis of the knee
Treatment of Patellofemoral arthrosis
Medication should be started immediately after diagnosis. This is very important, because it takes precious time, for which the joint is destroyed irrevocably. Since rubbing between them articular surfaces inevitably become inflamed, the purpose of anti-inflammatory drugs is indicated, most often the non-steroidal group is in demand. It is suitable not only for oral, but also topical application.
To protect the periarticular and cartilaginous tissue, the appointment of chondroprotecters as preparations for tissue nutrition, strengthening of the bone system is shown. In especially severe cases, prescribe muscle relaxants, medications to improve blood microcirculation and the means for its dilution.
Some medications, including hormones, can be injected into the joint. Intra-articular injections are prescribed more often. They act locally, which repeatedly increases the final therapeutic effect. At home, it is easy to use ointments and creams with anti-inflammatory and warming effects. Local irritation of the painful zone leads to an improvement in its innervation, blood flow, normalization of tissue trophism. If the treatment does not bring relief for a long time, the patient's condition worsens, the knee joint is destroyed under the action of Patellofemoral arthrosis, then endoprosthetics is shown - a complete replacement of the joint suffering from an ailment.
Surgical intervention is not a reason to be afraid for your health. On the contrary, it is capable in a short period of time to return to the person the former freedom of movement. Sometimes, this is the only way to restore efficiency and avoid disability.
Additional and Alternative Treatment of Patellofemoral Arthrosis
Since the diagnosis is very serious, then the treatment should be aimed at combating many consequences. Therefore, a therapeutic massage is prescribed, often repeated courses. They can be held several times a year, and ideally - once a quarter. If this is not possible, then you can do self-massage of knee joints, or use massage machines. The treatment is shown in the manual therapist. Manual therapy has brought relief to hundreds of thousands of patients. It improves cartilage nutrition, promotes the normal release of articular "grease", which prevents early abrasion of intraarticular articular surfaces. Through the work of the chiropractor it is easy to eliminate dislocations, subluxations - frequent causes of articular diseases.
Treatment with leeches normalizes blood coagulability, adequate nutrition of the joint, strengthens the ligamentous apparatus. It has practically no contraindications, painless, does not bring much discomfort. Hirudotherapy is useful to combine with physiotherapy. Usually, electrophoresis, magnetotherapy and laser therapy are prescribed.
Patients with Patellofemoral arthrosis are actively treated with folk remedies. Treatment with herbs should be under the supervision of a specialist, because some plants and taking non-steroidal anti-inflammatory drugs are two incompatible actions. In addition to herbs, good results are obtained by products of beekeeping, snake venom, medical bile, paraffin therapy.
It is necessary not to forget about thermal procedures - baths, compresses. They allow deeply warmed layers of periarticular tissues, which will immediately reduce the inflammatory process of the knee joint. You are treated in a comprehensive manner, use the opportunities provided to slow down the destruction of the joint structure.