Chondromalation of patella: degree, treatment

Features of the manifestation of patella chondromalacia

Chondromalation of the patella is a disease caused by degenerative changes in the cartilaginous tissues. This condition is accompanied by a loss of elasticity.

The cartilage becomes less elastic, gradually collapses. As changes in the structure of the knee joint appear painful sensations.

They are provoked by the increased load exerted on the underlying bone.

Causes of development

It is necessary to imagine exactly where the changes are taking place. Cartilage itself does not have innervation, so the symptoms of the disease manifest themselves when the bone is overloaded.

Cartilage tissues have a smooth surface, they are elastic, which allows the joint to actively move. This is a kind of connective layer between the femur, the tibia and the patella.

Chondromalacia begins to develop from the deregulatory processes of the cartilage of the posterior surface of the patella. Depletion of cartilaginous tissue can occur in other parts of the femoral-patellar articulation.

However, if the factors contributing to the development of this pathological condition are not eliminated, after a while it will be necessary to again face this disease.

If a patellar chondromalia is diagnosed, the causes of this pathology can be followedThings:

• Increased physical stress on the joints. In such conditions, usually there are professional athletes in the directions of running and jumping. Changes in cartilaginous tissue begin with regular intensive work of the joints of the lower extremities on flexion-extension.
• Anatomical features. Women are more likely to develop degenerative processes in the tissue structure of knee joints than men.
• Pathologies diagnosed at birth. Most often, the displacement of the patella occurs.
• Hypotension of muscles (quadriceps). In this case, the movement of the joint can be difficult due to weakness in the tissues that hold the knee cap.
• Muscle imbalance. With this condition, knee joint hondromalation develops because of the difference in the levels of the exposed load. The muscles of the outer thigh are much more developed than the inner.
• Injury, which led to a violation of the integrity of the cartilaginous tissue. Such a risk is present if the exercises are incorrectly performed.
• To provoke the disease can and repeated deformation of cartilage of the patella.
• Age changes. In older people, pathology develops against the background of arthritis. In most cases, the degenerative state of cartilage is diagnosed in young people, adolescents.

Degrees of disease

Chondromalacia develops gradually. In this case, the degenerative process goes through 4 stages. Each of them is accompanied by different symptoms, which is caused by worsening of the patient's condition. Degrees of chondromalacia:

1. The first. In patients with pathology of the joint of 1 degree, thickening of some parts of the cartilaginous tissue appears. They are soft to the touch. In addition, the cartilage produces swelling. At this stage of pathology development, the first signs appear - painful sensations, but while they are not intensive. In this case, on the recommendation of the attending physician, the joint cavity is flushed.
2. The second. If no treatment was performed at stage 1 of the pathology of the knee joint, degenerative processes will continue to develop. In patients with pathology of grade 2, considerable depressions appear on the cartilaginous tissue, gaps up to 1 cm in size. Such deformations lead to the appearance of severe pains, which are often chronic. The second degree of the disease is diagnosed more often among athletes who ignore the discomfort manifested at the initial stage of the development of degenerative processes. In this case, a resection procedure can be recommended - a surgical procedure in which excision of damaged cartilage areas with special scissors is performed. After that, the joint is washed, as in the first stage of the disease.
3. The third. In this case, the cartilaginous tissue is deformed more strongly. In patients with pathology of the joint of the third degree, cracks and depressions appear on connective tissues larger than 1 cm. Sometimes the cartilage deforms so much that the bone opens. If the question is solved, how to treat a pathology of grade 3, it should be borne in mind that the resection procedure in this case is ineffective. Often, joint plasty is required, in which the pathologically changed tissues are replaced with healthy ones.
4. Fourth. This is the most serious stage in the development of degenerative processes. Patients with pathology of the 4th degree have a naked subchondral bone.

Symptomatology

For a number of signs, it is possible to suspect the development of a degenerative process in the structure of the knee joint. Symptoms of chondromalacia of the patella are few.

Some of them manifest themselves infrequently under the influence of a number of factors: varying degrees of intensity of deformation of the cartilaginous tissue, the general condition of the patient's body and the genus of his activity.

Symptoms are as follows:

• Pain syndrome. At early stages of development of pathology weak pains are noted, they arise periodically. As the situation worsens, the discomfort in the joint increases. The pain becomes intense, manifested after the physical exertion.
• Puffiness. This is one of the signs of chondromalacia, but it does not always appear. Most often, edema develops after physical exertion on the lower limbs.
• Atypical crunch. If earlier the patient periodically had specific sounds when bending the knee joint and this was due to physiological features, then there is no reason for excitement. In the case when the crunch appears as a result of the effects of excessive loads, this can be a cause for concern against the background of manifestations of other symptoms: puffiness, pain.

Factors contributing to the development of discomfort in the patella: gymnastics (certain exercises, for example, squats), running, climbing stairs, the need to often go down on their knees, exercise, which indicates the impact of increased stress on the joints of the lower extremities. Painful sensations can arise with a long stay in the sitting position (in an airplane, car, office). Provokes the development of chondromalacia is also overweight.

Diagnosis and prognosis

The doctor conducts an external examination, palpation can reveal swelling, swelling of the tissues. The main methods of diagnosis in the pathology of the knee:

1. X-rays, and the procedure is performed in the axial projection (legs bend at the knee at an angle of 45 °);
2. with the help of CT and MRI, a patellar position change (inclination or subluxation) is detected;
3. arthroscopy of the knee joint - is prescribed in cases, if there are signs of development of arthrosis, this procedure allows to determine the degree of severity of the pathological condition.

The prognosis of this disease is positive. If the treatment is started in time, you can gradually return the elasticity of the cartilage tissues, strength and endurance to the muscles. Subject to the recommendations, the cartilage is restored to its original state.

Healing measures

As a result of the diagnosis determine the severity of the disease. In most cases, good results allow for conservative treatment. It includes a number of activities:

• taking painkillers, non-steroidal anti-inflammatory drugs, with which you can stop the development of pathological processes, remove discomfort;
• therapeutic physical culture (LFK), in this case it is important to do the exercises correctly, so as not to aggravate the condition of the knee joint.

With LFK, a specialist performs gymnastics aimed at strengthening the muscles. And it is important that the exercises are not dynamic, but static.

For chondromalacia of the patella it is recommended to use a bandage fixing the joint. Such a measure will allow to remove excess load from cartilaginous tissue and patella.

The bandage fixes the joint in the correct position, which excludes the formation of subluxation.

For the time of restoration of the knee, stop training, remove any physical strain.

In the case when conservative treatment does not give the desired results, the situation is corrected by the method of operative intervention.

The choice of the procedure is determined by the state of the damaged cartilage tissue. In addition, to remove symptoms in this pathology can be folk methods:

1. Apply to the inflamed joint cold, prolonged exposure to low temperatures will ensure the outflow of blood from the affected tissue.
2. Treatment of the knee joint with lemon juice. This makes it possible to reduce pain.
3. Onion broth. It is made from 2 onions and 1 liter of water. Onion is peeled, finely chopped, then the components are combined and boiled. Drink the medicine three times a day for 200 g. The duration of the decoction is 1 week.
4. Sunflower oil. It will take only 1 tbsp. l. The oil is heated and rubbed into the knee joint.
5. If edema develops, a fresh cabbage leaf is applied. Do this before bedtime. For a night swelling will come down. It is recommended to fix the leaf on the foot with a bandage.
6. Propolis can be rubbed into the knee joint. For this purpose, prepare 1 tbsp. l. substance. He rubbed in a circular motion, without exerting pressure on the affected area.

Do not rely solely on folk recipes. With their help, it is impossible to completely cure the chondromalation of the patella.

In those cases when it is not possible to completely exclude the factors contributing to the appearance of degenerative processes in the structure of the cartilage, In the future, there are difficulties in the movement of the knee joint: it is problematic to climb the stairs, squat, engage sports.

A source: https://OrtoCure.ru/kosti-i-sustavy/drugoe/hondromalyatsiya-kolena.html

The causes of chondromalation of the patella, methods of diagnosis and treatment

Chondromalation of the patella is a pathological condition in which the structure of cartilage tissues in the joint region changes, while the cartilage loses its elasticity and softens.

The disease is considered frequent among young people, especially among athletes, as it occurs in most cases under the influence of loads on the knee joint area.

If you disassemble the very name of the disease, chondro means cartilaginous tissue, and malation is softening.

Normally, the cartilaginous tissue ensures the joint sliding and its protection, while the patellar cartilage has an even structure, but under the influence of negative factors, it loses its strength, which causes the symptoms of pain, discomfort.Consider what threatens a person with chondromalation of the patella, what methods of diagnosis and treatment are used.

The presence of concomitant pathologies of the musculoskeletal system aggravates the course of the disease, while chondromalacia of the patella is often combined with arthrosis, arthritis, osteoporosis and other diseases joints.

The defeat of articular cartilage with chondromalacia occurs on the posterior surface of the joint, while if the disease is not treated, over time the degenerative process passes to other parts.

Thus, the area of ​​the medial condyle of the thigh, the entire patellar zone and the bones themselves are affected. With such a course of the disease has a second name - arthrosis in the femoral-patellar articulation.

We will analyze what causes and risk factors lead to pathology of the patella and thigh, that is, to chondromalacia.

Causes

The disease in most cases affects people of a young age, since it is associated with loads on the knees, lower legs and thighs. By the way, that's why chondromalacia is also called the "knee runner".

So, we can identify the first group of risk - it's athletes, especially runners, athletes. In the second group of people predisposed to chondromalacia, equate those who suffer from arthrosis of the hip and knee.

In their case history, the diagnosis is referred to as "arthrosis in the femoral-patellar articulation."

It happens this not only with sports, but also with physical exertion, so people are exposed to the disease, which, due to the peculiarities of their work, are worth a lot or go around.

Often people suffer from various joint deformities when the angle of the axis of the hip bone and the tibia increases. Sometimes the chondromalation of the patella is recorded in people with congenital defects in the structure of the patella or thigh itself.

If you take into account the sexual characteristics, the chondromalacia of the patella is more common in women, which is often associated with pregnancy, childbirth.

More correctly, with features of a structure of bones of a pelvic area. And also an important role is played by accompanying pathologies, such as diabetes, osteoporosis, hormonal failures.

Among other reasons it is possible to distinguish the traumas, hypothermia.

Symptoms

Chondromalation of the patella begins gradually and depends on the degree of destruction of the cartilage.

Initially, the knee joint region hurts slightly, mainly after exercise, especially in athletes. The knee begins to puff.

In older people, the increase in pain may be due to weather change, that is, they begin to become meteodependent.

With progression, the disease manifests itself with constant pain in the anterior part of the knee, and soreness increases with exercise.

The knee is very sore when climbing the stairs, during squats. When examined, the patient is swollen in the knee joint area.

The destruction of the cartilage leads to the appearance of a characteristic feature - a crunch and clicks during movements.

In total, the disease is distinguished by 4 degrees of progression.

The pathological process begins from the first degree, when the diagnosis reveals cartilage swelling and the beginning of the malting, that is, the softening of the cartilage tissues.

The third degree of knee joint damage is accompanied by the development of cracks, which in diameter reach more than a centimeter, and often reach the bones.

During this period, a person begins to suffer from severe pain, the appearance of effusion and crepitus in the knee. Such symptoms are not characteristic of all patients.

By the way, if you do not treat the disease in the third degree, then because of the limitation of mobility, atrophy of the hip muscles develops.

The last, the fourth degree leads to destruction of the cartilage, its nutrition is disturbed and eventually the subchondral bone is exposed.

During this period, the person, in addition to the symptoms of severe pain, sharply reduced motor activity, of course, he can not exercise and even physically work. Appears obvious lameness.

Diagnostics

Prescribing treatment without conducting a thorough examination of the knee joint is impossible, as chondromalacia has similarities with other pathologies that affect the musculoskeletal system. In addition, a comprehensive examination is necessary to identify conditions leading to the destruction of cartilage.

When there is pain and discomfort in the knee, you need to see a doctor - an orthopedist. It is he who will study the complaints, will conduct an examination.

During the examination and questioning, the patient complains of soreness in the anterior part of the knee, which increases with the load, so the doctor will offer to sit down several times.

When studying the physical signs in the chondromalacia of the patella, there may be an effusion, weakening of the muscles hip, up to their atrophy, also the symptoms of pain due to the narrowing of the femur-patellar articulation at load.

After the examination and palpation was performed, the doctor prescribes an X-ray - a picture. With the help of radiation diagnosis, typical changes can be found for arthrosis, although at the first degrees of the disease the X-ray may not show any changes.

This is precisely what should alert the doctor. For accurate diagnosis, an X-ray examination in the axial projection is required, when the leg is bent at the knee 45 degrees, a picture is taken.

A more accurate picture of the state of the cartilaginous tissue will show a computer tomography or MRI.

If the above diagnostic methods do not allow an accurate diagnosis, the patient undergoes an arthroscopic procedure, which, incidentally, is also used for a therapeutic purpose. When all the diagnostics are done, the doctor selects individual treatment.

Treatment

In most cases conservative methods of treatment of knee joint chondromalacia are used. Restoration will require compliance with a special regime, when you need to ensure a direct position for the patella for a longer period of time. For this it is recommended to wear a knee.

Medication

With severe pain, you need to alleviate the patient's condition, for which he is prescribed anti-inflammatory drugs. These can be drugs from the NSAID group:

• diclofenac, is given a short course and quickly relieves pain with intramuscular injection;
• ibuprofen - can be used up to 2 weeks in the form of tablets, it is safe for children and young people;
• nimesulide - used in the form of powders, tablets and capsules, quickly relieves pain;
• movalis - the safest, but expensive drug from this group, in the first 3 days is used intramuscularly, after which it is necessary to give it in the form of tablets;
• Ketorolac is a strong drug for pain, but it does not relieve inflammation itself.

To restore the knee joint, you can not only apply the drugs inside, but also use the treatment with various ointments, creams. Voltaren, Diklak-gel, Amelotex, Dolgit-gel, Apizartron, Indomethacin ointment are good for helping.

In cases of severe inflammation, especially when there is concomitant arthrosis or other joint diseases, hormone therapy is prescribed. Used drugs from the group of glucocorticosteroids.

In general, the radical method allows you to get rid of joint pain from 1 to 3 months, includes also blockade in the joint with hormones in solution with Lidocaine (Novokain).

The goal of the treatment of chondromalacia is not only to save the patient from pain, but also to prevent further destruction of the cartilaginous tissue.

For this purpose preparations of group of chondroprotectors which promote collagen production, strengthening of a cartilaginous tissue are appointed.

There are 6 groups of chondroprotectors:

1. The 1st group includes chondroitin sulfate-based drugs such as Chondroxide, Arthron, Structum, they are effective in the early stages of cartilage destruction.
2. Group 2 - chondroprotectors of animal origin (especially from cartilage of fish). This includes taking Rumalon or Alflutop.
3. To the third group of chondroprotectors equals the preparations of a number of mucopolysaccharides, they are rarely used in treatment.
4. The 4th group is common in the treatment of diseases of the musculoskeletal system and is called glucosamine preparations. It includes the reception of Dona, Arthron-Flex.
5. The most common is the 5th group and it includes complex funds based on chondroitin sulfate and glucosamine, such as Teraflex, Chondroxide maximum, Arthron.
6. To the 6-th group include the combined funds, when the drug, in addition to chondroprotectors, contains a component of NSAIDs, as in the preparation Teraflex Advance with ibuprofen.

All these preparations have a lot of advantages, but they need to be taken for a long time, at least a month, and only then they will start to act. Modern methods of treatment of chondromalacia include intraarticular administration of derivatives of chondroprotectors and sodium hyaluronate.

Other treatments

Taking certain medications is unlikely to completely restore the mobility of the knee and get rid of the symptoms of the disease.

Therefore, the patient is prescribed a course of physiotherapy for the knee, which must be taken in conjunction with the massage. In general, with chondromalacia an important stage is recovery after drug therapy.

To do this, the doctor selects the patient exercises for the passage of medical gymnastics.

During the rehabilitation period, it will be necessary to protect the knee from the loads, from injuries, and wear comfortable shoes.

If necessary, the doctor will advise using a stick or cane.

To strengthen the joints and the body as a whole, prevention with vitamin therapy is needed. Particularly important is the intake of B, D and calcium vitamins.

If conservative treatment does not help, the patient will be shown to perform the operation. Naturally, recovery after surgery will be long, and a person at a young age will be able to regain his ability to work and even play sports, but in a sparing regimen.

A popular method is arthroscopy, which allows not to leave large scars, minimally injure tissues. With the help of an arthroscope, the affected areas of the cartilage are excised. If the cartilage is badly damaged, then surgical treatment is appointed according to the type of reconstruction.

When the operation is completed, the patient is waiting for recovery, for which he is given a massage, exercise therapy and physical therapy.

A source: http://drpozvonkov.ru/sustavy/prichiny-xondromalyacii-nadkolennika-sposoby-diagnostiki-i-lecheniya.html

Chondromalacia of the knee joint: causes, symptoms, diagnosis and treatment methods

For the full-fledged life of any person, it is very important to move easily and painlessly, but, unfortunately, in the elderly, and young people often have various diseases of the limbs, in which even simple walking becomes difficult.

One of them is chondromalacia of the knee joint. By name it is clear that this ailment affects the knees, which are the most complex joints in the human body. Their main function is to provide leg mobility.

Discomfort in the knee always causes some stiffness of movement, and more serious problems with this joint lead to disability. The knee consists of a multitude of parts, and in each, deformities can result, leading to particular specific diseases.

This article provides information on the destruction of cartilage on the surface of a small bone, called a patella.

The structure of the knee

In order to clearly imagine what kind of an ailment this is - knee joint knee dromalacia, let's recall from what parts our knees are composed.

They are based on two large bones (upper femoral and lower tibia) and one small bone (patella, called in the people by the kneecap). The patella serves as an additional lever when flexing / unbending the knee.

On all sides, this small bone is surrounded by bundles, so it can move slightly in different directions.

In addition to bones, there are ligaments in the knee, a capsule covering and protecting the entire joint, menisci and cartilage. In the capsule there are 6 bags, 3 of which are located on the patella - two in front and one in the back. They produce a synovial fluid, which is extremely important for joint work.

The structure of the cartilage

To denote a state where pain suddenly occurs in the knee, the expression "tuck your knee" has long been used in the people.

In medicine, this condition is considered a disease that has little in common with the displacement of any part of the joint and is called chondromalacia of the knee joint. It means the destruction of the patella's cartilage covering its inner part.

The thickness of the cartilage in this place is a maximum of 10 mm. It has an elastic, but at the same time, a dense consistency and a smooth surface. The role of the cartilage is to reduce the friction of the bones and to absorb shock loads.

In its structure this cartilage is hyaline, very elastic, but not as durable as fibrous cartilage, which is the basis of meniscuses. It consists of water (80%), organic substances (15%) and mineral salts (5%). It feeds his articular fluid.

Causes of cartilage destruction

Chondromalacia in the knee can be diagnosed in people of any age. The causes of the disease can be as follows:

- knee injuries;

- deformation of the joints;

- congenital, as well as acquired as a result of certain diseases, anomalies in the development of parts of the joint;

- age-related changes, such as a decrease in the formation of synovial fluid that feeds the cartilage.

However, most often this disease is observed in young, full-strength people who are too active in sports, as a result of which give their knees exorbitantly high loads.

In this category are mainly athletes, especially those who are engaged in football, weightlifting, hockey, figure skating. But not only sportsmen-professionals develop chondromalacia of cartilage of the knee joint.

Such people give loads to their legs to a lesser degree, but they, in view of the fact that they are engaged without a coach, often perform incorrectly various exercises that lead to microtraumas of the knee joint.

Among other reasons that cause the destruction of hyaline cartilage, we can name:

- imbalance in muscle tone;

- trauma of the femur and tibia, which form the knee joint;

- injuries of the patella;

- overweight (obese people with walking constantly heavily load their lower limbs);

- wearing uncomfortable shoes, which can create additional stress on the knee joint;

- congenital or acquired deformities of the feet.

Classification

Depending on how far the destruction of cartilage has gone, chondromalacia of the knee joint is divided into four stages:

- the first one, at which deformities only begin, therefore the symptomatology is weak, and the treatment is sufficiently effective;

- the second, characterized by the appearance of microcracks in the cartilage, which causes quite noticeable painful phenomena;

- the third, at which the cracks deepen, in some cases reaching the bone;

- the fourth, the most neglected, requiring very complex and expensive treatment.

Let us consider these degrees in more detail.

First degree

Chondromalacia of the 1st degree of the knee joint is distinguished by the fact that the very first deformations appear in the cartilage - its the tissue starts to soften a little, and on the surface of the joint noticeable small painless seals. With pressure, they can cause only mild discomfort, so many people neglect this symptom.

What else is characteristic for the onset of the development of the disease? These first signs include a crunch in the knees or something resembling clicks, especially noticeable when a person rises from the crooks, climbs the stairs, performs certain exercises, for example, bends the leg so that the heel touches the buttocks, and then her right. To guard should and painful sensations after long sitting with the bent legs or foots.

If you immediately go to a doctor for such symptoms, treatment can be limited to a sparing regimen, diet and the intake of dietary supplements - chondroprotectors.

Second degree

Chondromalacia of the 2nd degree of the knee joint begins as a consequence of the untreated 1 degree of the disease with the saved intense rhythm of life and physical exertion.

At this stage, the cartilage is stratified into fibers, cracking, but the area of ​​damage does not exceed 13 mm.

The person feels pain in sudden movements (lifting from a chair, the beginning of a run or walking, exercises in which you want to bend and unbend legs). The second degree is noticeable and visually. With her affected knee swollen, it may reddening the skin.

Treatment in this case can be conservative and include physiotherapy, medication, restriction of exercise. In this case, the primary goal of doctors is to remove pain syndromes, after which to start the restoration of cartilage.

Third degree

Chondromalacia of the third degree of the knee joint is considered to be a severe and practically irreversible type of destruction of the cartilage body.

It continues to separate into fibers, the depth and number of cracks on it increase, and the area of ​​deformations already considerably exceeds 13 mm. This stage of the disease can occur in acute and chronic forms.

When an acute person feels pain in the knee, regardless of whether it performs sharp or smooth translational movements. Characteristic features include:

- inflamed skin in the area of ​​the affected joint;

- restriction of mobility;

- great difficulties when doing squats.

Treatment of the third degree is more prolonged and expensive, and doctors do not always guarantee the complete restoration of the cartilaginous tissue.

For relief of pain and early restoration of cartilage tissues, an injection in the knee joint is often prescribed, which should be performed only by an experienced specialist - an orthopedist or traumatologist.

For the removal of the inflammatory process, intramuscular injections and physiotherapeutic procedures can be prescribed.

Fourth degree

Chondromalacia of the knee joint of the 4th degree is observed when the patient did not treat his knees at all, or treated them insufficiently, for example, only stopped the pain.

At this stage of destruction, the cartilage is so significant that it reaches the bone. In the future, it also begins to deteriorate, which almost always leads to disability.

Outwardly the 4th degree is expressed by the reddening and swelling of the knee, sometimes it is painful to touch it.

A person with such deformations of the joint is difficult to move without using special means (canes, crutches). Sometimes, at 4 degrees of chondromalacia, patients complain of general deterioration.

Diagnostics for an orthopedist

With the above symptoms, you need to contact an orthopedist, or, if the doctor does not have such a specialty in the polyclinic, to a traumatologist or a surgeon. The diagnosis begins with an anamnesis.

The doctor finds out whether the patient had a knee injury, specifies the nature of the pain, and performs a visual examination.

The patient is then given an X-ray (preliminary diagnosis is made), arthroscopy (this is a procedure for inserting a miniature arthroscope into the joint cavity), MRI or CT.

How to treat knee joint chondromalacia?

In this disease the methods of therapy depend on the degree of destruction of the cartilage.

As mentioned above, at grade 1, only conservative treatment is prescribed, including:

- Mandatory wearing of a knee brace or special fixative bandage, and recently kinesiotypes are often used;

- change in the level of physical exertion on the legs;

- therapeutic physical training;

- drugs or dietary supplements with chondroitin sulfate or glucosamine.

At 2 and 3 degrees, first of all, therapy is performed to relieve inflammatory symptoms. After this, the doctor can prescribe a resection of the deformed area of ​​the cartilage.

At the end of this procedure, the joint cavity is washed with saline solution. If the resection is not possible, the doctor will prescribe a fracture implantation.

Another method of therapy - a prick in the knee joint of a solution of hyaluronic acid.

It improves the quality of synovial fluid, promotes the restoration of cartilage tissue, reduces inflammation.

After pricking or resection, restorative therapy is necessarily performed, appointed Physiotherapeutic procedures in the form of applications of paraffin or ozocerite on the knee, laser and magnetic therapy, electrophoresis. Also, the patient drank the course of chondroprotectors and vitamins. Among the drugs popular are "Arthron" and "Arthron Complex "Teraflex" and "Teraflex Advance "Structum "Chondroitin Akos".

At 4 degrees of these measures may not be enough, as most often the restoration of cartilage tissue of the knee joint is very doubtful.

In such cases, perform complex operations of osteochondral plasty, stem cell transplantation, tunneling, which consists in making a multitude of holes in the subchondral bone.

As a result of these targeted injuries, the body forms a connective tissue that is capable of covering cartilage defects.

Tips of the healers

Chondromalacia of the knee joint is a serious disease, the symptoms of which can not be ignored.

Recipes of doctors from the people will not be able to restore cartilage tissue, but they help to remove pain and for a while to return the joy of movement.

So, when the inflammation of the knee joint is worsening, healers are advised to apply ice to the problem site. Such cryotherapy will help avoid edema. In the future, cold compresses should be replaced with warm compresses.

As an adjuvant in parallel with the main treatment, you can drink herbal teas, for example from chicory with a cranberry leaf. Relieve pain and swelling helps and attached to the knee fresh cabbage leaf or cloth, moistened in a solution with propolis. Some healers advise you to rub a warm unrefined lean oil into your knee or rub a patella with half a lemon.

Regardless of the result of the use of folk methods, a visit to a doctor for people who have knee pain is mandatory.

Prevention

To prevent knee joint chondromalacia, doctors give such recommendations to athletes:

- Do not start the basic training, without having previously warmed up and warming up the muscles;

- When carrying out any strength exercises have on your knees special bandages - knee pads.

General recommendations suitable for all people are:

- watch your weight;

- Do not wear uncomfortable shoes, and it is important that she was with the insteps;

- avoid injuries and heavy loads on the legs.

In addition to treatment, a diet with chondromalacia of the knee joint is important. It consists in the refusal of soda, smoked products, fatty foods, hot dogs.

It is necessary to reduce the amount of carbohydrates and salt in the diet, and increase the consumption of fruits and juices of them, jelly, caviar, marmalade on natural agar, dairy products, red fish, nuts, raisins.

Forecast

The chances for a complete restoration of the knee joint in the destruction of articular cartilage depend on the stage at which the disease is started, as well as the restorative capacities of the organism patient.

Exact predictions doctors do not give, but there is no doubt that the chondromalacia of the knee joints 1 degree can be cured completely provided that the patient complies with all the recommendations orthopedist.

With disease 2 and 3 degrees after resection of the cartilage requires a long rehabilitation.

At grade 4, the joint cartilage is not completely restored, but the patient is returned to the possibility of painless walking and other movements.

A source: http://.ru/article/326759/hondromalyatsiya-kolennogo-sustava-prichinyi-simptomyi-diagnostika-i-metodyi-lecheniya

Degrees of knee joint chondromalacia: diagnosis and treatment

Knee joints - this is the place of constant physical exertion and frequent injuries. As a result, not only the bones of the articulation suffer, but also its cartilage. Often there is chondromalacia of the knee joint.

What is chondromalacia?

The destruction of cartilage in the knee joint is called chondromalacia. The joint itself may remain intact. Sometimes chondromalacia occurs in parallel with joint diseases - osteoarthrosis and arthritis. The disease is known since the beginning of the XX century.

In order to assess how seriously the cartilage is damaged in this disease, trauma specialists have developed more than five classifications.

The most convenient was the classification of the degree of destruction of cartilage. It is most often used in practical medicine.

In the damage to the cartilage, four degrees were identified:

1. The first degree - the cartilage begins to soften and swell.
2. The second degree - it is divided into parts, cracked, the cartilaginous surface is stratified into individual fibers. At the second degree only a small area of ​​cartilage is damaged, with a diameter of not more than 1 mm.
3. The third degree of damage is the further destruction of the cartilage. It cracks, is divided into fibers in several layers. The diameter of the area of ​​damage is more than 1, mm.
4. Fourth degree - the destruction reaches the bone, there is a significant defect in the cartilage.

Disease Clinic

Chondromalacia of the knee joint can manifest itself in different ways. The most common symptoms are:

1. Pain. It can be aching or sharp, similar to a spasm. Sometimes the joint hurts only from the front, if the patella is affected, and sometimes all - regardless of the site of injury.
2. Sensation of a crunch in the knee. Especially often it appears when climbing or descending the stairs.
3. Blockade of the joint. Jamming of the joint is not entirely characteristic for chondromalacia, but sometimes it happens. Such blockades are called soft because of erased symptoms.
4. Moderate restriction of movements. More often movements in the knee joints are preserved in full, but at the third - the fourth degree can be somewhat limited.
5. Swelling, swelling of the knee. It can appear with the development of inflammation.
6. The instability in the joint. Sometimes this feeling is described as slipping. Occurs in 30% of cases.

Diagnosis and treatment after confirmation

Methods of confirming the diagnosis are arthroscopy - examination of the joint cavity with the help of an endoscope and magnetic resonance imaging. Preliminary diagnosis is made by X-ray.

Treatment is mandatory?

Despite the inexpressiveness of complaints, this disease must be treated. After the fourth degree of destruction of the cartilage, bone begins to damage - deforming osteoarthritis of the knee joint develops.

Liquid can accumulate in the joint cavity. This leads to a deterioration in the state and the appearance of new complaints. For the treatment of chondromalacia conservative and surgical methods are used.

Conservative therapy

This kind of treatment can help only at the beginning of the disease - with the first and second degree of damage to the cartilage. In conservative therapy, both physiotherapeutic procedures and medicines are successfully used.

Physiotherapy and physiotherapy

In the process of treatment it is desirable to limit the load not only to the knee area, but also to the entire body.

When practicing physiotherapy exercises, preference should be given to exercises to strengthen the quadriceps muscle of the thigh.

Physiotherapeutic procedures for chondromalacia use magnetotherapy, ultrasound, laser therapy.

Medication

The main drugs for chondromolation are nonsteroidal anti-inflammatory drugs. Most often it is diclofenac sodium in various forms and its analogs. These drugs relieve inflammation in the area of ​​the knee joints and remove pain.

Prolonged use of anti-inflammatory drugs is fraught with the development of bleeding and the formation of ulcers and erosions in the stomach and intestines. Also, when using them, the condition of the blood coagulation system should be checked regularly.

To treat this disease, chondroprotectors - chondroitin, glucosamine - are also used.

However, convincing evidence of their effectiveness in the treatment of chondromalacia has not yet been obtained.

Sometimes drug therapy is complemented by treatment with hyaluronic acid and its analogues. Such drugs are injected into the joint, usually by a long course.

At the third and fourth stage of destruction of cartilage tissue, it is usually resorted to operative treatment.

Types of surgical intervention

Before performing an operation, trauma doctors should assess the degree of damage. This is possible with diagnostic arthroscopy. Endoscopic examination of the joint from the inside allows you not only to decide on surgical tactics, but also immediately to conduct surgical intervention.

Thanks to the arthroscope, you can monitor the progress of the operation without dissecting the joint. Usually, local anesthesia is used in combination with intravenous anesthesia. The scope of surgical intervention depends on the severity of the process:

1. If the first degree of damage is detected, it can be limited to washing the joint cavity. For this, physiological saline is used, in a volume of about two liters.
2. The second and third stages of cartilage destruction require its partial removal - resection. To remove, unstable, damaged areas are selected. The cartilage is resected to a healthy layer using special scissors. Operative intervention, as in the first stage of destruction, is completed by washing the joint cavity with saline.
3. The fourth degree of damage is the most difficult condition for surgical treatment. In this case, the cartilage is destroyed at significant intervals, and conventional resection will not save the situation. Often, bone-cartilage plasty, cartilage or stem cell transplantation is required. At this stage, the subchondral bone is also subjected to surgical treatment. A special screw or a spoke in it is made a lot of holes. This process is called tunneling or creating micro-fractures. The destruction of the bone causes the body to restore it. At the site of the holes, connective tissue is formed, which, expanding, covers the defects of the cartilage.

Postoperative period

The duration of postoperative treatment depends on the type of surgical intervention.

In the case of endoscopic surgery, inpatient treatment takes no more than a week, then continues on an outpatient basis.

Full physical loads are resolved from the third to the fourth week. Immobilization (immobilization) of the limb is not required.

After any operation, rehabilitation procedures are shown - physiotherapy, physiotherapy exercises and swimming in the pool.

A source: http://MedOtvet.com/drugie-bolezni-sustavov/stepeni-hondromalyacii-kolennogo-sustava-diagnostika-i-lechenie.html