Patellofemoral arthrosis of the knee: symptoms and treatment

Features of arthrosis patellofemoral joint

The term "patellofemoral arthrosis" is used only by physicians 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.

The 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).

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

Where is this joint, features of anatomy

"Patella" 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.

An important role in instability in patellofemoral arthrosis is given to the types of patella configuration. There are 3 options:

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

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

Smooth gliding 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.

From the lateral (external) side there are superficial and deep ligaments, 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 is still no pronounced changes in the x-ray, the symptoms of inflammation. Therefore, the general classification of arthrosis is not applicable to the disease.

The pathological displacement of the patella is often caused by chronic long-term illnesses rather than traumas. Excess weight is considered one of the main factors of instability of the joint.

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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, pathological displacement to the side, damage to the femoral surface of the joint and tibia (turn outward).

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The mechanism of falling or bruising is taken into account in the diagnosis. Trauma is accompanied by subluxation or dislocation of the patella.

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

Symptoms

Such clinical manifestations as pain in walking, limping, swelling and "clicks" in the knee Joints are common, but are not specific symptoms for changes in patellofemoral articulation.

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

• pain limited only to the front of the knee;
• sharply increased or appear in the squat position, as well as when lifting from a chair after a long sitting position;
• The soreness is felt when climbing the stairs.

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 of acute and prolonged pain on the anterior surface of the knee after strong loads, sports training, carrying heavy loads, descending and climbing the stairs, disappear on their own when rest;
• the third one is characterized by initial dystrophic changes in articular surfaces, the pain syndrome does not disappear, treatment is required.

How to identify the disease

Since radiographically patellofemoral arthrosis of the knee joint is expressed by very scanty signs, the doctor should be guided by the collected anamnesis on complaints, the mechanism of an overload or a trauma, survey of the knee.

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

What does the traumatologist pay attention to when examining the patient

The 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. The 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" upward. 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. Determination of pain when 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.

When palpation of the joint, the doctor draws attention to the presence of effusion, tenderness of soft tissues in the patellar tendon, ligamentous apparatus

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

• radiography of the knee;
• magnetic resonance tomography;
• CT scan.

Therapeutic tactics

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

To support the patella, special orthoses or tight bandages are used.

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

As an analgesic therapy recommend:

• non-steroidal anti-inflammatory drugs;
• analgesics;
• compresses with ice.

If a connection with arthritis or arthrosis of the knee is identified, the administration of anti-inflammatory hormonal agents into the cavity of the joint capsule

Constant pains indicate a clinic of arthritis. 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).

Home methods of treatment

At home, you can prepare tinctures for grinding and compresses, apply baths.
A productive way are compresses with tincture of chamomile, flax seeds, decoctions of herbs (horse chestnut, chamomile, elder, sweet clover, burdock, arnica, dill).

What to do for prevention

To prevent patellofemoral syndrome it is necessary:

• control your weight;
• Do not overeat, eat vegetables, fruits, protein foods daily;
• pay attention to training the muscles of the legs;
• athletic loads to begin with a warm-up of muscles;
• buy shoes with a good shock-absorbing stock of the sole;
• Do not delay wearing special insoles with flat feet.

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.

A source: http://MoyaSpina.ru/bolezni/osobennosti-artroza-patellofemoralnogo-sustava

Patellofemoral arthrosis of the knee joint: features of the disease and treatment

Patellofemoral arthrosis of the knee joint is a specific medical term widely used to diagnose pathologies associated with abnormal development of the cartilaginous joint tissue.

Causes of the disease

Patellofemoral arthrosis occurs for a variety of reasons, in particular, such as:

• deformation of the joint;
• pathology of development and functioning of the knee joint;
• increased load on the knee;
• old age.

This disease can occur in the presence of any of the causes or a whole complex of pathologies and disorders.

Features of the course of the disease and symptoms

Osteoarthritis of the patellofemoral articulation of the knee arises mainly due to excessive loads on a certain area of ​​the body. Over time, the pathology can pass into arthrosis. The syndrome is characterized by the following symptoms:

• feeling of stiffness of movements;
• painful sensations and a crunch in the patella;
• discomfort and tenderness when trying to bend the legs in the knee.

Symptoms of the disease largely depend on the degree of its severity.

At the first degree, no structural changes are observed in the patellar region, and the development of pathology can be recognized by the presence of pulling unpleasant sensations in the knee region.

In this case, the patient is shown complete peace, perhaps with a local application of cold. It is also necessary to avoid overloading the knee joint in the future.

The second degree is characterized by the fact that the structure changes and the damage to the cartilaginous tissue begins.

Clinically, this manifests itself in the form of intense pain, which increases with the movement of the knee, which can limit the motor activity of the patient.

In this case, examination and subsequent treatment is required.

As for the third degree of pathology, when performing an X-ray, one can see a deformation of the patellofemoral joint, which becomes an indication for the operation.

Conducting diagnostics

Diagnose patellofemoral arthrosis only clinically. The doctor conducts a palpation of the outer and inner sides of the knee joint.

Additional laboratory tests and clinical tests to establish a diagnosis are not required. Initially, the doctor determines the painful points by shifting the patella to the sides.

Often, there can be bilateral patellofemoral arthrosis, which is why the diagnosis should be complex. In some cases, radiography and ultrasound are used to confirm the diagnosis.

Symptomatic treatment

With significant loads and the presence of pathologies of cartilaginous tissue, patellofemoral arthrosis of the knee joint may occur.

Treatment in this case is aimed at eliminating the existing painful sensations and restoring the damaged cartilage and joints.

With minor pains, it is often enough to carry out symptomatic therapy, which involves:

• decreased motor activity;
• carrying out cryoprocedures;
• introduction of drugs into the joint tissue (injections).

In the presence of pain, it is necessary to reduce the loads exerted on the knees. If it is necessary to perform movements, you need to use fixative bandages, knee pads, elastic bandages.

Minor pain helps to eliminate cryoprocedures. To do this, prepare ice cubes, put them in cotton cloth, folded in several layers, and apply to a sore spot. Such compresses will help to remove pain after the load on the knee joint and relieve tension.

Knowing how to treat patellofemoral arthrosis, you can get rid of the syndrome at the initial stage and prevent its further development, as well as the occurrence of complications.

Physiotherapy sessions

When conducting complex therapy, it is necessary to include in the treatment program and physiotherapy procedures.

Often, laser therapy is used, which implies the use of a focused beam of light.

This method helps in the course of stages 2 and 3 of the syndrome.

Patellofemoral arthrosis is also treated by applying magnetic resonance therapy, ultrasound, thermal therapy, cryotherapy, electrophoresis. The best effect is provided by cryotherapy, which implies the use of liquid nitrogen.

Medication Therapy

If patellofemoral arthrosis is diagnosed, the treatment implies the use of medication, in particular, such as:

• anti-inflammatory drugs;
• chondroprotectors;
• compresses, rubbers.

Anti-inflammatory drugs help to remove severe pain. Often used such means as "Diclofenac "Ketoprofen "Indomethacin "Ibuprofen".

Chondroprotectors are used to repair damaged cartilage tissue of the knee joint. They are available in tablet form, as well as in the form of ointments and creams.

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Among the tablets it is necessary to allocate medicines "Structum "Don "Teraflex "Chondroitin".

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Among the ointments and creams "Voltaren "Viprosal "Diklak gel" have proved to be well, as they improve elasticity and promote the strengthening of muscle fibers. "Finalgel" and "Nikofleks" help to improve blood microcirculation.

To eliminate the pain and inflammation, additionally designate various rubbers.

Among such means it is necessary to allocate "Dimexide applied in the form of compresses. The duration of the procedure is from half an hour to an hour.

To eliminate signs of arthrosis, you need to undergo a full course of treatment, consisting of 20 procedures.

"Bishofit" promotes resorption of arthrosis. To get the desired effect, you need to apply a compress in the knee area and wrap it with a dense woolen cloth.

Compresses with medications are widely used for therapy. They help to remove pain and inflammation.

Patellofemoral arthrosis of the first and second stages is well treated and by using intraarticular injections. As drugs, anesthetics, glucocorticosteroids, chondroprotectors are used.

Folk techniques and wearing orthopedic shoes

Osteoarthritis of the patellofemoral joint is treated and with the help of folk techniques that help get rid of unpleasant sensations and achieve significant improvement in well-being.

Normalize the metabolism helps mocryric, which is why it must be consumed in food, adding to the first dishes or salads. It is also used as a tincture for rubbing the knees.

To prepare the product, you need to pour 2 tablespoons of chopped grass with vodka and insist in a dry dark place.

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Widely used and burdock. You can apply to the sore spot fresh burdock leaves, but you can mash them up a bit, dip them into alcohol and attach them to the affected area, and then wrap the knee with a film and a warm cloth. Leave the burdock leaves for the whole night.

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At the initial stage of the pathology, you must try to minimize the motor load, and also additionally shows the use of special means for fixing the knee the joint. For this, elastic knee pads are used.

Surgical intervention

If conservative therapy did not bring the desired result, patellofemoral arthrosis of the knee joint is treated by performing a surgical procedure.

In particular, arthroscopy is carried out.

The operation involves the execution of a small incision, through which an arthroscope is inserted into the cavity of the affected joint.

The device is equipped with a camera, which allows you to carefully remove the damaged cartilage and replace them if necessary with an artificial cloth.

After the operation, it is necessary to undergo a course of rehabilitation, which implies recovery of motor activity, compliance with a special diet, as well as the implementation of special exercises.

During the rehabilitation, decoctions of herbs, warming trays and compresses are widely used.

Main methods of prevention

To prevent the occurrence of arthrosis in the knee joint, it is necessary to carry out preventive maintenance. For this, you must:

• take a bath with sea salt;
• regularly rubbing with alcohol tinctures;
• to take herbal medicinal herbs;
• Healthy food;
• give enough time to sleep and rest;
• limit consumption of salty, sweet and smoked foods.

In addition, for preventive and curative purposes, you need to perform special exercises to strengthen the muscles and ligaments of the knee joint. If you experience the first painful sensations, you should always contact the doctor, as timely treatment will help quickly get rid of pathology.

A source: http://.ru/article/309469/patellofemoralnyiy-artroz-kolennogo-sustava-osobennosti-bolezni-i-lechenie

Patellofemoral arthrosis: symptoms and treatment

Category: Joints, bones, muscles 4351

• Pain in the knee
• Stiffness of movements in the knee joint

The concept of patellofemoral arthrosis in international medical practice is absent.

Most often this term is used to describe the initial stage of the development of arthrosis, for which the manifestation of symptoms is not characteristic.

This disease requires timely diagnosis and proper treatment so that complications do not develop.

General clinical picture

Patellofemoral syndrome occurs as a consequence of the load on the same part of the body. Pain in the knee joint often develops and progresses due to functional dysfunction.

It is almost impossible to acquire this syndrome due to mechanical trauma alone. The greatest danger is that over time, if not begin timely treatment, the syndrome can develop into arthrosis of the knee joint.

The latter is treated much more difficultly, and there is no guarantee that the result will be positive.

In some cases, the syndrome can develop against a background of another ailment. Most often, the "basis" for its development becomes varus deformity of the joint or instability of the patella.

However, if we are talking about the damage to the calyx on the background of the loads, the patellofemoral arthrosis of the knee joint can pass with time itself.

But, this does not mean that you can neglect a visit to a doctor and postpone treatment.

Symptomatology

Patellofemoral arthrosis is characterized by such signs:

• stiffness of movements in the knee joint;
• painful sensations at a load, rise on height;
• discomfort and aching pain when trying to sit with bent legs.

These symptoms are very similar to the symptoms of many other joint diseases, so it is necessary to conduct differential diagnosis.

The doctor will be able to make an accurate diagnosis and prescribe treatment only after diagnosis.

In this case, more informative are instrumental methods - ultrasound of joints, radiography.

Treatment

If the patellofemoral arthrosis does not cause severe pain, then the treatment does not provide for medication. the purpose of therapy is to restore the functionality of the joint, and also to reduce all unpleasant symptoms.

If the pain does not go away for a long time or is periodic, the doctor can prescribe chondroprotectors intra-articularly. By the way, the periodic nature of pain for this syndrome is quite normal.

Mandatory procedures for this type of arthrosis are as follows:

• restriction of loads (to almost complete elimination of pain);
• fixation of the calyx by means of a special bandage;
• use of injections to prevent inflammation.

Please note that only a doctor should prescribe a treatment. Independent application of any procedures can not only not bring a positive result, but also worsen the situation.

As for the injection of injections, they help not only to avoid the inflammatory process, but also greatly accelerate the process of recovery.

However, the doctor appoints such procedures only in the event that there is frequent acute pain. Injection should be done under pressure and strictly in fibrinous tissue.

If the medicine falls into the knee cavity, then there will be no benefit.

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If the patellofemoral arthrosis of the knee cap is not burdened by other diseases, then with proper exercises of physical therapy and reducing the load, serious treatment will not be needed. In the event that the pain and stiffness of movements do not pass for a long time, you should pay a second visit to the doctor and continue the course of recovery.

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Diseases with similar symptoms:

Rupture of the meniscus (coinciding symptoms: 2 of 2)

A meniscus rupture is one of the most common internal injuries of the knee joint.

Often subject to it are professional athletes, but this disorder is not excluded in people who are not associated with constant overstrain of the lower extremities.

There are two types of meniscus external (lateral) and internal (medial). Often such a disease is diagnosed in people from eighteen to forty.

In children under the age of fourteen, the disorder is rare. The rupture of the medial meniscus of the knee joint is more common than the external one. It is very rare to break the two menisci simultaneously.

... Coxarthrosis (coinciding symptoms: 1 of 2)

Coxarthrosis, whose symptoms during the late stages of its course manifest itself in the form of muscle atrophy affected area in conjunction with the shortening of the limb, develops in a gradual manner, in the period several years.

... Flat-footedness (coinciding symptoms: 1 of 2)

Flattening - this is a kind of deformation of the foot area, in which its vaults are subject to lowering, resulting in a complete loss of their inherent damping and spring functions.

Flat feet, the symptoms of which consist in such basic manifestations as pain in the calf muscles and sensation stiffness in them, increased fatigue in walking and prolonged standing, increased pain in the legs at the end of the day and others.

, is the most common disease affecting the feet.

... Osteoarthritis (coinciding symptoms: 1 of 2)

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Osteoarthritis is a fairly common disease in which joints are degenerative and dystrophic.

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Osteoarthrosis, the symptoms of which are initially associated with the gradual disintegration of cartilaginous tissue, and then with the decay of the subchondral bone and other structural constituting the joint, develops against the background of a lack of oxygen in them and can manifest itself in various forms with different areas of localization of the pathological process. In general, this disease is diagnosed in patients aged 40 to 60 years.

... Osteochondrosis of the knee joint (coinciding symptoms: 1 of 2)

Osteochondrosis of the knee joint (dissecting) is a disease of a degenerative-degenerative type. It mainly affects people at a young age, in most cases has a favorable course and ends with the recovery of patients.

...

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A source: http://SimptoMer.ru/bolezni/sustavy-kosti/911-patellofemoralnyy-artroz-simptomy

Peculiarities of patellofemoral arthrosis of the knee joint

It happens, after consulting a doctor, we have to ask ourselves: "Patellofemoral arthrosis of the knee joint, what is it?".

In order to determine this medical formulation, for starters, you need to have an idea of ​​what patella is and what it is for.

Purpose of patella

The patella is a flat bone of a small size of an irregular geometric shape.

Its upper edge, in the optimal version, is an isosceles triangle without a base, with the formation of a lower corner slightly more than 90 degrees.

But there are deviations in its structure, considered as variants of the norm.

The patella is an additional bone located in the thickness of the tendon of the quadriceps femoris muscle.

Its inner surface, in contact with the lower articular end of the femur, is covered hyaline cartilage, which causes damage to the development of patellofemoral arthrosis of the knee the joint.

The physiological function of the patella consists in increasing the area of ​​the knee joint and strengthening the muscular traction of the femoral muscles, based on the lever principle of biomechanics.

Causes of patellofemoral arthrosis

Most of the patellofemoral arthrosis of the knee joint is a secondary process and accompanies osteoarthritis of the knee joint (gonarthrosis).

Congenital features of the structure of the patellofemoral joint, in the event of additional conditions, are also capable of forming patellofemoral arthrosis of the knee joint.

So after all, arthrosis or syndrome?

Given the fact that the connection of the femur with the patella is not in itself a joint, the term "arthrosis in this case is somewhat unqualified and it will be more correct to talk about patellofemoral syndrome. Syndrome - a set of symptoms accompanying a particular disease.

If this syndrome is considered in the structure of gonarthrosis, then it is obvious that the changes in the patellar base of the patella go in parallel with those changes in the surfaces of the knee joint.

If you treat with a predilection for separating one condition from another with ostearthrosis of the knee joint, then you should pay attention to the characteristic of the patellofemoral pain syndrome.

Symptoms of patellofemoral syndrome

The peculiarity is the occurrence of pain in strictly defined points or the provocation of pain by a certain position of the injured lower limb.

In the case of gonarthrosis, a complex of diagnostic and therapeutic measures aimed at patellofemoral syndrome fits into the general scheme of medical prescriptions for osteoarthritis of the knee joint.

Patellofemoral pain syndrome is characterized by:

• Feeling of discomfort along the anterior surface of the knee with spread to the thigh;
• Strictly localized pain with diagnostic palpation and attempted patellar bias in one direction or another;
• The appearance of intense pain with the maximum flexion of the lower limb in the knee. Inability to squat, difficulty climbing up the steps.

Degrees of severity of the disease.

• At 1 degree, no structural changes in the patella are observed, and the entire clinic fits into sensation of either drawing unpleasant sensations, or not pronounced pain along the front surface of the knee.

• Patellofemoral arthrosis of the knee joint of the 2nd degree is characterized by the onset of destruction of the cartilaginous tissue and can be accompanied by a subluxation of the patella. Clinically, there is quite intense pain, which is aggravated by provoking flexion movements of the knee. Pain can limit the motor activity of the patient. On an independent cessation of pain, in this case, no longer have to count;
• If the disease develops to grade 3, then radiological evidence becomes apparent, gross defects patellofemoral articulation (often including the knee joint), which becomes an indication for reconstructive surgery.

Treatment

The patellofemoral pain syndrome is treated mainly in the second and third stages of the disease.

If the first degree of the disease is characterized by spontaneous cure, in the case of providing the necessary rest to the damaged lower limb, then subsequent degrees the progression of the disease requires the use of anesthetic drugs from a group of non-steroidal anti-inflammatory drugs or non-pyogenic analgesics of the central action (catadolone).

The therapeutic approach is to use a short course of non-steroidal anti-inflammatory drugs, with a subsequent or parallel transition to long-term use of chondroprotectors.

A physiotherapeutic treatment is prescribed, including laser therapy, UHF therapy, electrophotophoresis with hydrocortisone, ozocerite wraps. Attention is paid to the soft fixation of the patella by kinesiotheip or orthosis, wearing comfortable shoes that relieve the load from the hip.

In the case of coarse deformity of the joint, along with severe osteoarthritis of the knee joint, endoprosthetics are performed. If the original cause of this pathology were anatomical features, then the question of orthopedic plasty of ligaments fixing the patella is solved.

Who it will be, the therapist, rheumatologist or traumatologist-orthopedist depends on each specific case. Health!

A source: http://zdorovie-sustavov.ru/osobennosti-patellofemoralnogo-artroza-kolennogo-sustava.html

Treatment of patellofemoral arthrosis of the knee joint

Table of contents

• How is this disease treated?
• Traditional methods of treating the disease

Patellofemoral arthrosis of the knee joint, the treatment of which is performed under the supervision of a physician, is not a separate disease.

The international classification of diseases includes patellofemoral syndrome, which has the same symptoms and causes.

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Diseases of the joints of the musculoskeletal system most often occur against the background of functional disorders and degenerative processes.

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What is patellofemoral arthrosis? This term means a pathological condition in which the destruction of the knee joint, consisting of the joint surface and the femur, occurs. Inflammatory process is localized under the knee cap.

How is this disease treated?

For the treatment of patellofemoral arthrosis, complex multi-stage techniques, as well as expensive medications, are not required.

However, you should not abandon the prescribed therapy. It is recommended to start it with the immobilization of the joint and reduce the loads exerted on it.

To eliminate the unpleasant sensations used:

• anti-inflammatory drugs;
• physiotherapeutic procedures.

The joint is immobilized with the help of special means, which limit any movements associated with the affected area. It can be an orthosis or bandage worn on the knee.

To eliminate the unpleasant sensations arising in the background of patellofemoral arthrosis, painkillers and anti-inflammatory drugs are prescribed - Diclofenac, Meloxicam. They are available in the form of:

• tablets;
• solutions for injections;
• ointments;
• grits.

Such medicines can produce a large number of side effects:

• headache;
• nausea;
• pain in the epigastric region;
• skin rash.

Everything depends on the tolerability of the components of the drug.

For the investment of pain in the early stages of the disease, it is sufficient to use external agents, for example, cold compresses.

Osteoarthritis of the knee joint of the 2nd degree is an indication for the use of intra-articular injections of glucocorticosteroids. The drug enters directly into the inflamed joint.

As a rule, after the treatment course signs of the disease disappear quickly, no dangerous consequences are observed.

Degenerative changes in those or other departments of the musculoskeletal system are most often found in elderly people, they require a long-term comprehensive treatment. To do this, apply:

• drugs that improve blood circulation;
• restoring metabolism;
• slowing the destruction of cartilaginous tissues.

After improving the general condition, physiotherapeutic procedures can be used:

• electrophoresis;
• ultrasound;
• radon baths;
• mud treatment.

These or other therapeutic methods for patellofemoral arthrosis of the second degree should be selected by the attending physician.

Based on the results of the examination and examination, the specialist prescribes medicinal preparations, surgical interference and other procedures that are selected depending on the degree of symptoms disease.

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During the operation, the damaged parts of the joint are replaced with prostheses, which helps restore the functions of the affected department. Arthroscopy is a surgical procedure performed using an arthroscope.

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In the region of the knee, a small incision is made through which the instruments are inserted and the affected parts of the cartilage and the synovial membrane are removed.

Traditional methods of treating the disease

There is a large number of folk methods that allow you to get rid of the unpleasant sensations associated with arthrosis of the knee joint.

1. Mokrytsa improves the general condition of the body, normalizes metabolism. It is eaten in the summer season, adding to salads or first courses. For external use, tincture is prepared: 2 tbsp. l. raw materials are poured into vodka and kept in a dark cool place. Infusion of licorice is used to rub the sick knees.
2. Another useful recipe: 2 tbsp. l. sunflower oil is heated, not leading to a boil, and then rubbed into the affected area. To get rid of the pain, there are enough 5 similar procedures.
3. Apple cider vinegar is diluted with water in the ratio: 0, the resulting solution is taken 3 times a day.
4. Especially often in the treatment of patellofemoral arthrosis use a burdock. There are two ways to use this tool. Leaves of the plant pile up with a velvety side up, then leave under the press for several hours. The knee is smeared with warm vegetable oil and a ready-made remedy is applied to it. The compress should be left overnight.
5. The burdock sheet is kneaded until the droplets of juice appear, after which they are dipped into alcohol and applied to the affected area. A polyethylene film and a warm cloth are put on top. The procedure is recommended to be performed before bedtime, in the morning the compress is replaced. On day 3, the burdock leaf is used in combination with crushed garlic, 4 on Vishnevsky ointment. Cabbage is no less effective. The leaves are kneaded and smeared with honey, applied to the knee and fixed with a bandage. In the morning, the compress is removed, the skin is washed with warm water. The course of treatment lasts 30 days.
6. Gauze is soaked with celandine juice, then applied to the affected area. The lotion is held for an hour, after which a warm vegetable oil is applied. Treatment should be carried out for 7 days, after which you need to take a short break. To get rid of signs of patellofemoral arthrosis, it takes 3 courses.

A source: https://OrtoCure.ru/kosti-i-sustavy/artroz/patellofemoralnyj-kolennogo-sustava-lechenie.html

Patellofemoral arthrosis of the knee joint treatment, methods of therapy and prevention, video of the complex of exercises

Patellofemoral arthrosis of the knee joint is a medical term used for diagnosing associated with the development of the articular cartilage pathology of the knee.

Official world medicine does not single out this disease in a separate category, preferring the wording "patellofemoral syndrome".

What is it, and why do Russian doctors in practice and scientific articles essentially equate these concepts?

Methods of therapy of the knee joint with patellofemoral arthrosis

The term "patellofemoral" is formed by combining two concepts: patella - patella, femur - femur.

Patellofemoral syndrome is the initial stage of development of pathology of the knee joint, accompanied by a number of symptoms.

The main symptom is a dull, aching pain in the patella, which increases with:

• additional physical exertion: walking, climbing and descending stairs, running;
• long pastime squatting;
• sitting with bent knees.

To the accompanying negative sensations in patellofemoral arthrosis can be attributed a slight crackle or crunching in all kinds of physical activity.

In medical practice, patellofemoral arthrosis of the knee is also called chondromalacia.

Pathological processes of destruction of the cartilage body, reducing the amount of joint fluid lead to increased friction of the bones of the knee, causing painful sensations.

The causes of chondromalacia changes of the knee are:

• Overload.
• Age changes in the body.
• Injuries of the knee - fractures, dislocations, nadkols.
• Violations of the structure.

The onset of pain in the patella is an occasion for a specialist.

The need for this is justified by the need to exclude more serious variants of development of pathologies, as well as determining the degree of destruction of the knee joint.

To appoint competent treatment, the doctor-traumatologist, orthopedist, artrologist will conduct clinical studies. The essence of the latter is:

• Exterior inspection. This will help to exclude other diseases, similar to patellofemoral arthrosis, and choose the direction of treatment.
• The delivery of a blood test - general and biochemical. Helps identify diagnostic options, determine the presence of inflammatory processes in the body.
• Detailed diagnosis for determining the stage of pathology:
  • X-ray examination. It helps to establish the extent of bone tissue damage, the stage of the disease development. Minus - does not give information about the state of soft tissues surrounding the patient's knee joint.
  • Computer tomography, which helps to make a volumetric model of the joint. Of the minuses: a significant dose of radiation.
  • MRI. Gives the fullest idea of ​​the structure of bones, cartilage, articular capsule and soft tissues and helps to establish the methodology of treatment more precisely.
  • Ultrasound.

With minor manifestations of the pain syndrome of patellofemoral arthrosis of the knee, symptomatic treatment is often sufficient and effective:

• Reduced motor activity, aimed at limiting the load on the knee. If necessary, perform any movement: walking, climbing stairs, any work in the "standing on knees it is preferable to use fixative bandages: elastic bandages, special soft knee pads, orthoses.
• Easy pain can be well helped to remove the cryo procedure. Prepare ice cubes. Fold the cotton cloth in several layers, lay out the ice cubes and form a small pouch. To relieve the symptoms of pain after a knee load, the ideal treatment will be cold compresses, lasting no more than 5 minutes, each procedure.
• Attacks of acute, severe pain as a result of repeated trauma of the knee joint or in the presence of patellofemoral arthrosis in athletes, dancers, gymnasts are well removed by injections into the fibrous tissue (ring) that help to fix the capsule of the joint at the edge kneecap. The introduction of a mixture of anesthetic and glucocorticosteroids according to patients' opinions prevents the growth of pain, relieves inflammation, eliminates the need for drug treatment.

Physiotherapy sessions

As a part of complex treatment, physiotherapeutic procedures are effective:

• Laser therapy. With this method of treatment, a focused light beam of ultraviolet, red and infrared directivity is used. It is good for I and II stages of arthrosis.
• Magnetic resonance therapy. The effectiveness of treatment of exposure to a magnetic field is about 50%.
• Ultrasound radiation. Includes the mechanical effect of "sound waves the thermal effect of energy conversion and the acceleration of biochemical processes in the knee joint under the influence of ultrasound.
• Cryotherapy: dry (treatment of patellofemoral arthrosis under the influence of very low temperature) and liquid (treatment with liquid nitrogen). The latter option gives more results for joint arthrosis.
• Thermal therapy. Includes paraffin wraps of the knee, ozocerite baths, mud treatment.
• Electrophoresis. Used zinc, lithium, sulfur, in some cases - dimexide.

Medications

Appoint competent medical treatment will only be able to specialist, having conducted appropriate tests and diagnostics. Allopathic methods of treatment of patellofemoral knee syndrome include complex therapy, which is objectively necessary in the II and III stages of the disease development:

• Non-steroidal anti-inflammatory drugs NSAIDs. A feature of the application is the "cleaning" of the symptoms of pain, because it is possible to start a full-fledged treatment only by relieving the exacerbation of arthrosis. The use of non-steroid drugs should be under the supervision of the doctor in a dosage corresponding to the indications on the leaflet of the drug. These include: Aspirin, Diclofenac, Indomethacin, Ketorolac, Ketoprofen, Ibuprofen and their derivatives.
• Chondroprotectors, whose spectrum of action is aimed at restoring the cartilaginous tissue of the knee:
  • Pills:
    • monopreparations - Dona (glucosamine), Structum (chondroitin sulfate),
    • complex - Teraflex, Chondroitin Akos.
  • Ointments, gels, creams:
    • Diklak gel, Voltaren, Apizatron, Viprosal - improve the elasticity of muscle fibers.
    • Finalal, Nikofleks - contribute to the improvement of blood flow, vasodilation.
• Rastirki, which, absorbed through the skin, relieve inflammation or pain:
  • Dimexide. It is applied in the form of compresses. The duration of the procedure is from 30 minutes to 1 hour. Course: up to 20 procedures.
  • Bischofite is an oil brine that helps resorption of arthrosis. To do this, make a "coat" for the knee: impregnate with a cloth, wrap, wrapping the top with a woolen cloth. Leave for 3 hours. The course of treatment: 10-15 procedures.

• Compresses based on medical preparations. The compress, made on the basis of taken in an equal share of honey, medical bile, glycerin, iodine and ammonia, relieves pain painfully. Insist 2 weeks in a dark place. Then the warmed up compound to put or render on area of ​​a knee joint for 20-30 minutes.

Intra-articular injections

Effective in the treatment of the first two stages of patellofemoral arthrosis of the knee joint. Injections are used:

• Glucocorticosteroids and anesthetics - Diprospan, Hydrocortisone, Prednisolone.
• Hondoprotectors, "liquid prostheses" based on sodium hyaluronate: Dyurrolan, Synvisc, Ostenil.

Special gymnastics for strengthening the muscles of the joints

Effective exercises in the treatment of gonarthrosis will be static exercises:

• Take the position lying on the back, bending the left leg at an angle of 50-60. Raise your right foot 15-20 cm from the floor, pull the toe on yourself and hold in this position for 30 seconds. Change your foot. Do at least 10 exercises in two sets at intervals of 5 minutes.
• The starting position is the same as for exercise 1. Tear off the foot from the floor, raising it by 20-30 cm. Pull the sock toward you, fixing it for a couple of seconds. Then pull the lift (like a ballerina) for 1-2 seconds. Repeat for each leg 10 to 15 times.
• Lying on the floor on your stomach, tear off the upper body from the floor, while lifting one leg to a height of 15-20 cm. Hold for a few seconds, gently take the starting position. Change your foot. Do it 10-15 times.
• Semi-squats, performed at a slow pace, are effective for the development of knee muscles. The frequency of execution is from 10 to 15 times.
• Easy stretching, standing on straight legs, lunges on one leg - excellent preventive methods of treating the disease.

Wearing orthopedic shoes and knee pads

At an initial stage of development of a pathology it is possible to be limited to decrease in an impellent loading, use of special means of fixing of a knee joint: orthoses - elastic knee pads.

To avoid the development and progression of patellofemoral arthrosis, comfortable high-quality footwear with orthopedic characteristics, good cushioning properties - a must-have patient suffering from chondromalacion syndrome.

Surgical intervention

Individual cases may require surgical intervention.

To be sure of the need for surgery, do not hesitate to consult several specialists, making maximum use of the possibilities of conservative treatment.

If the deformity of the knee led to an almost complete destruction of cartilage, and chondroprotectors and hyaluron do not help, it will be necessary to fight the disease by surgical intervention:

• Arthroscopy. Through a small incision, a medical instrument is inserted-an arthroscope into the cavity of the damaged joint. It is equipped with a camera that helps the surgeon gently remove the damaged cartilage. Then, it is possible to use the procedure of artificial joint prosthesis, consisting of titanium plates.
• Lateral release. This is a dissection of the patellar ligament in order to return it to its original position. Rehabilitation after surgical treatment is aimed at restoring the motor function of the knee joint, optimization of diet, moderate exercise, gradual refusal to take medicines preparations. The folk remedies and methods will be good: warming baths, herbal decoctions, compresses.

In order not to require the treatment of patellofemoral arthrosis of the knee, it is necessary to comply with the general requirements and recommendations of orthopedists for the prevention of pathology:

• Lifestyle change:
  • moderate exercise, giving the ability to train the muscles of the knee;
  • weight loss with excess weight;
  • refusal from bad habits - smoking and drinking.
• Normalization of diet: the right diet is the main source of vitamin and micronutrient intake.
• Wearing comfortable shoes with orthopedic characteristics.
• Do not engage in self-medication, and with a painful syndrome consult a doctor.

Therapeutic gymnastics is one of the main and most effective methods of combating pathology.

Preliminary consult with your doctor about the dosed load: without exercise, progress in treatment will be minimal.

In the period of exacerbation, you can not perform therapeutic gymnastics! Having looked through our video, you will learn, what complex of exercises will help to strengthen muscles of a knee and to get rid of symptoms patellofemoral arthrosis.

A source: http://vrachmedik.ru/26-patellofemoralnyi-artroz-kolennogo-sustava-lechenie.html