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

For a full-fledged life for any person, it is very important to move easily and painlessly, but, unfortunately, in the elderly and young people there are often various limb diseases, in which even simple walking becomes difficult. One of them is the 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 ensure 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 specific specific diseases. This article provides information on the destruction of cartilage on the surface of a small bone, called the 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, popularly called the patella). The patella serves as an additional lever when flexing / unbending the knee. It has two surfaces - outer, rougher, and inner, more flattened, covered with cartilage. The patella has an irregular rounded shape, in which the base (top) and the pole (bottom) are distinguished. 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 an unusually important synovial fluid for joint work.

The structure of the cartilage

To denote a state where pain suddenly occurs in the knee, the expression "tucking the 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 that covers 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 cartilage is to reduce the friction of 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 such a disease is observed in young, full- strength people who are too active in sports, as a result of which give their knees an exorbitantly high load. In this category there 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. Sports fans who want to maintain their body in perfect shape are also familiar with knee problems. 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 microtrauma of the knee joint.

Among other reasons that cause the destruction of hyaline cartilage, you can call:

- imbalance in muscle tone;

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

- injuries of the patella;

- overweight (obese people always very 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 differs in that the very first deformations appear in the cartilage - its tissue starts to soften slightly, and small painless seals become noticeable on the surface of the joint. With pressure, they can cause only slight 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 crook, climbs the stairs, performs certain exercises, for example, bends the leg so that the heel touches the buttocks, and then straightens it. 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 gentle regimen, diet and 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 it, the affected knee swells, it can redden 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 break down 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.

In chronic form, a person experiences constant dull aching pain while walking, increasing, for example, when climbing the stairs. Often these movements are accompanied by a crunch or faint clicks.

Treatment of the third degree is more prolonged and expensive, and doctors do not always guarantee a 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 - orthopedist or traumatologist. For the removal of the inflammatory process, intramuscular injection and physiotherapy procedures may 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 collapse, 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

With the above symptoms, you need to contact the 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 has had a knee injury, specifies the nature of the pain, and performs a visual examination. Then the patient is given an X-ray (preliminary diagnosis is made), arthroscopy (this is the procedure for inserting a miniature arthroscope into the joint cavity), MRI or CT.

How to treat knee joint chondromalacia?

With 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-bandage or special fixative bandage, and recently kinesiotypes are often used;

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

- therapeutic exercise;

- 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. The material for the implant is taken from the patient's healthy cartilage, so that the tissues are 100% acclimatized.

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 injections or resections, restorative therapy is mandatory, physiotherapeutic procedures in the form of applications of paraffin or ozocerite on the knee, laser and magnetic therapy, electrophoresis are prescribed. Also, the patient drank the course of chondroprotectors and vitamins. Among the drugs are popular "Arthron" and "Arthron Complex", "Teraflex" and "Teraflex Advance", "Structum", "Chondroitin Akos".

With 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. Prescriptions of doctors from the people will not be able to restore cartilage tissue, but they help to remove pain and for a while to bring back the joy of movement. So, when the inflammation of the knee joint worsens, healers are advised to apply ice to the problem area. Such cryotherapy will help avoid edema. In the future, cold compresses should be replaced with warm compresses. To do this, you can use alcoholic infusions of the field buttercup, chestnut, sabelnik, burdock roots with eleven. Preparing tinctures on a general principle. As an adjuvant, in parallel with the main treatment, you can drink herbal teas, for example from chicory with cranberry leaves. 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 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 chondromalacia of the knee joint, 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:

- monitor 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 is important in the chondromalacia of the knee joint. 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 from them, jelly, cold, marmalade on natural agar, dairy products, red fish, nuts, raisins.

Forecast

The chances for a full restoration of the knee joint with the destruction of the articular cartilage depend on the stage of the disease at which the treatment is started, as well as the restoring abilities of the patient's body. The doctors do not give exact predictions, but there is no doubt that the chondromalacia of the knee joints of the 1st degree is completely cured if the patient complies with all the orthopedist's recommendations. With disease 2 and 3 degrees after resection of cartilage requires a long rehabilitation. At grade 4, the joint cartilage is not completely restored, but the patient returns to the possibility of painless walking and other movements.