For a full life, for any person, the ability to easily and painlessly move is very important, but, unfortunately, elderly and young people often experience 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 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 many parts, and in each deformation can begin, leading to individual specific diseases. This article provides information on the destruction of cartilage on the surface of a small bone called the patella.
Knee structure
To clearly imagine what kind of ailment this is - chondromalacia of the knee joint, let us recall what parts of our knees are made of. Their basis is two large bones (upper femur and lower tibial) and one small bone (patella, popularly referred to as the patella). The patella serves as an additional lever for flexion / extension of the knee. It has two surfaces - the outer one, more rough, and the inner one, more smooth, 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 ligaments, so it can be slightly shifted in different directions.
In addition to the bones, the knee has ligaments, a capsule that covers and protects the entire joint, menisci and cartilage. The capsule has 6 bags, 3 of which are located on the patella - two in front and one in the back. They produce synovial fluid, which is extremely important for joint function.
Cartilage structure
To indicate the condition when pain suddenly arises in the knee, the phrase “tuck the knee” has long been used by people. In medicine, this condition is considered a disease that has little to do with the displacement of any part of the joint and is called chondromalacia of the knee joint. It means the destruction of the cartilage of the patella, 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 dense texture and smooth surface. The role of cartilage - during movement, reduce bone friction and absorb shock loads. By its structure, this cartilage is hyaline, very elastic, but not as strong as the fibrous cartilage, which is the basis of the menisci. It consists of water (80%), organic matter (15%) and mineral salts (5%). It nourishes its joint fluid.
Causes of Cartilage Destruction
Chondromalacia in the knee can be diagnosed in people of any age. The causes of the disease may be as follows:
- knee injuries;
- joint deformities;
- congenital, as well as acquired as a result of some diseases, abnormalities in the development of parts of the joint;
- age-related changes, such as a decrease in the formation of synovial fluid that feeds cartilage.
However, most often this disease is observed in young, full- bodied people who are too active in sports, as a result of which they give exorbitantly high loads to their knees. This category consists mainly of athletes, especially those involved in football, weightlifting, hockey, figure skating. But not only professional athletes develop chondromalacia of cartilage of the knee joint. Sports enthusiasts seeking to keep their bodies in perfect shape are also familiar with knee problems. Such people give loads to their legs to a lesser extent, but because they are engaged without a trainer, they often perform incorrectly various exercises that lead to microtrauma of the knee joint.
Among other causes of the destruction of hyaline cartilage are:
- imbalance in muscle tone;
- injuries of the femur and tibia that make up the knee joint;
- kneecap injuries;
- excess weight (obese people when walking constantly 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 cartilage destruction has gone, chondromalacia of the knee joint is divided into four degrees:
- the first, in which the deformations are just beginning, so the symptoms are weak, and the treatment is quite effective;
- the second, characterized by the appearance of microcracks in the cartilage, which causes quite noticeable painful phenomena;
- the third, in which the cracks deepen, in some cases reaching the bone;
- the fourth, the most neglected, requiring a very complex and expensive treatment.
Let's 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 begins to soften a little, and on the surface of the joint small painless seals become noticeable. When pressed, they can cause only slight discomfort, so many people neglect this symptom.
What else is typical for the onset of the development of the disease? Such first signs include a crunch in the knees or something resembling clicks, especially noticeable when a person rises from the squat, climbs the stairs, performs certain exercises, for example, bends the leg so that the heel touches the buttocks, and then straightens it. Painful sensations after prolonged sitting with bent legs should also alert.
If you immediately consult a doctor with such symptoms, treatment may be limited to a sparing regimen, diet and taking dietary supplements - chondroprotectors.
Second degree
Chondromalacia of the 2nd degree of the knee joint begins as a result of untreated 1st degree of the disease while maintaining an intense rhythm of life and physical activity. At this stage, the cartilage is stratified into fibers, cracking, but the area of damage does not exceed 13 mm. A person feels pain during sudden movements (getting up from a chair, beginning to run or walking, exercises that require bending and unbending legs). The second degree is noticeable and visually. With it, the affected knee swells, redness of the skin is possible on it. In this case, treatment can be conservative and include physiotherapy, medication, and limiting stress. In this case, the primary goal of doctors is to remove pain syndromes, and then begin to restore cartilage.
Third degree
Chondromalacia of the 3rd degree of the knee joint is considered a severe and practically irreversible type of destruction of the cartilage body. It continues to stratify into fibers, the depth and number of cracks on it increase, and the area of deformations already significantly exceeds 13 mm. This stage of the disease can occur in acute and chronic forms. In an acute person, he feels pain in the knee, regardless of whether he performs sharp or smooth translational movements. The characteristic features include:
- inflamed skin in the area of the diseased joint;
- limitation of mobility;
- great difficulty in doing squats.
In the chronic form, a person experiences constant dull aching pains while walking, intensifying, for example, when climbing stairs. Often these movements are accompanied by a crunch or mild clicks.
Treatment of the third degree is longer and more expensive, while doctors do not always guarantee complete restoration of cartilage. To relieve pain and speedy restoration of cartilage tissue, an injection in the knee joint is often prescribed, which should be performed only by an experienced specialist - an orthopedist or traumatologist. To relieve the inflammatory process, it is possible to prescribe intramuscular injections and physiotherapeutic procedures.
Fourth degree
Chondromalacia of the knee joint of the 4th degree is observed when the patient did not treat his knees at all, or did not treat them enough, for example, he only stopped the pain. At this stage, the destruction in 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, grade 4 is expressed by redness and swelling of the knee, sometimes it is painful to touch it. It is difficult for a person with such joint deformities to move without the use of special means (canes, crutches). Sometimes, with 4 degrees of chondromalacia, patients complain of a general deterioration.
Diagnostics
With the above symptoms, you need to contact an orthopedist, or, if there is no such specialty in the clinic, to a traumatologist or surgeon. Diagnosis begins with a medical history. The doctor finds out if the patient had knee injuries, clarifies the nature of the pain, conducts a visual examination. Next, the patient is given an x-ray (a preliminary diagnosis is made), arthroscopy (this is the procedure for introducing a miniature arthroscope into the articular cavity), MRI or CT.
How to treat knee chondromalacia?
With this disease, treatment methods depend on the degree of cartilage destruction.
As mentioned above, at the 1st degree, only conservative treatment is prescribed, including:
- the obligatory wearing of a knee brace or a special retaining bandage, and recently kinesiotapes are often used;
- change in the level of physical exertion on the legs;
- physiotherapy exercises;
- drugs or dietary supplements with chondroitin sulfate or glucosamine.
At 2 and 3 degrees, therapy is first performed to relieve inflammatory symptoms. After that, the doctor can prescribe a resection of the deformed cartilage. At the end of this procedure, the joint cavity is washed with saline. If resection is not possible, the doctor prescribes the implantation of a crack. The material for the implant is taken from the healthy cartilage of the patient himself, so that the tissues are 100% taken root.
Another method of therapy is an injection in the knee joint of a solution of hyaluronic acid.
It improves the quality of synovial fluid, helps to restore cartilage tissue, reduces inflammation.
After injections or resection, rehabilitation therapy is necessarily carried out, physiotherapeutic procedures are prescribed in the form of applications of paraffin or ozokerite on the knee, laser and magnetic therapy, electrophoresis. Also, the patient drinks a course of chondroprotectors and vitamins. Among the drugs are popular "Arthron" and "Arthron Complex", "Teraflex" and "Teraflex Advance", "Structum", "Chondroitin Akos".
With 4 degrees, these measures may not be enough, since most often the restoration of cartilaginous tissue of the knee joint is already very doubtful. In such cases, complex operations of bone-cartilaginous plastic surgery, stem cell transplantation, and tunneling are performed, which consist of making many holes in the cartilage. As a result of these targeted injuries, the body forms connective tissue, which can close cartilage defects.
Healer Tips
Chondromalacia of the knee joint is a serious disease, the symptoms of which cannot be ignored. Recipes of doctors from the people will not be able to restore cartilage tissue, but they help relieve pain and for some time restore the joy of movement. So, with an exacerbation of inflammation of the knee joint, healers recommend applying ice to the problem area. Such cryotherapy will help to avoid edema. In the future, cold compresses should be replaced with warm ones. To do this, you can use alcoholic extracts of field buttercup, chestnut, saber, the roots of burdock with elecampane. Tinctures are prepared according to the general principle. As an adjuvant, along with the main treatment, you can drink herbal teas, for example from chicory with lingonberry leaf. A fresh cabbage leaf or tissue soaked in a solution with propolis also helps to relieve pain and swelling. Some healers advise rubbing warm unrefined vegetable oil into the knee or rub the patella with half a lemon.
Regardless of the result of the application of folk methods, a visit to a doctor for people whose knees hurt is a must.
Prevention
To prevent chondromalacia of the knee, doctors give these recommendations for athletes:
- Do not start the main workout without first flexing and warming up the muscles;
- when performing any strength exercises, have special bandages on your knees - knee pads.
General recommendations suitable for all people are:
- monitor your weight;
- Do not wear uncomfortable shoes, and it is important that it be with arch support;
- avoid injuries and heavy loads on the legs.
In addition to treatment, a diet is important for chondromalacia of the knee joint. It consists in the rejection of soda, smoked meats, 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, aspic, marmalade on natural agar, dairy products, red fish, nuts, raisins.
Forecast
The chances of a full restoration of the work of the knee joint during the destruction of articular cartilage depend on at what stage of the disease treatment is started, as well as on the recovery abilities of the patient's body. Doctors do not give accurate forecasts, but there is no doubt about the claim that chondromalacia of the knee joints of the 1st degree is completely cured, provided that the patient complies with all the recommendations of the orthopedist. With a disease of 2 and 3 degrees after a cartilage resection, a long rehabilitation is required. At 4 degrees, the articular cartilage is completely not restored, but the patient returns the possibility of painless walking and other movements.