Injuries to the knee structures sometimes lead to Pellegrini-Stida disease. It is named after the names of the surgeons who first described it. Development in the initial stages is often asymptomatic. This leads to untimely diagnosis and late treatment, which may be accompanied by complications.
Features and General Description
Pellegrini-Stida disease is a pathological bone proliferation characterized by a latent clinical picture. Speaking in scientific language, we are talking about the ossification of paraaticular tissues in the area of the epicondyle of the knee. The disease occurs most often due to trauma or regular microtraumatization against the background of significant joint loads.
The development of the pathological process begins with the formation in the muscle tissue of gusts of tendons, necrotic foci. Progression may be complicated by reactive periarthritis. First, a tendon is involved in the pathological process, and then synovial tissues. Periarthritis leads to tendobursitis. As a result, soft tissues swell in the structure of the knee. At the same time, the patient already experiences difficulties with movement, he is tormented by constant severe pain. Properly selected therapy leads to the disappearance of symptoms. Otherwise, residual manifestations of Pellegrini-Stida disease are detected, which leads to its transformation into a chronic pathology.
Main reasons
The predisposition to the disease is men aged 25 to 45 years, whose daily work is directly related to sports or physical activity. Provoking factors are direct mechanical injury to the thigh, a sharp abduction of the lower leg. In addition, the following factors can accompany Pellegrini-Stida disease:
- knee hemorrhage;
- necrotic processes in the periarticular tissues;
- hormonal disruptions;
- the presence of varicose veins;
- arthritis;
- trophic disturbances;
- prolonged swelling in the knee.
Doctors also warn of a hereditary predisposition to pathology. This is due to the genetic characteristics of bone growth. The presence of close relatives with its manifestations dramatically increases the likelihood of a recurrence of the diagnosis in the family. However, even in this case, a trigger in the form of an injury will be needed.
Clinical picture
For a long time, Pellegrini-Stida disease of the knee joint can be asymptomatic. At the same time, patients often complain of discomfort in this area, which only intensifies after exercise or sports. As the disease progresses, the clinical picture is supplemented by swelling, the appearance of pain, redness of the skin around the affected joint, and an increase in temperature in this area. In addition, difficulties with movement may occur, gait changes and lameness appears. In the case of a prolonged pathological process, the volume of motor activity is reduced. At the final stages of the disease, a person loses the ability to make full movements in the knee joint, ankylosis occurs.
Diagnostic Methods
The doctor may suspect Pellegrini-Stida disease of the knee joint after a physical examination and palpation of the affected area. To confirm the diagnosis, the patient is assigned an x-ray study simultaneously in several projections. With a pronounced pathological process, excess bone growths in the area of the diseased knee joint are clearly visualized in the image. In order to determine the degree of damage, an MRI and CT scan is required. A blood test is also mandatory to determine the amount of calcium in the body.
Conservative therapy
There are two ways to treat Pellegrini-Stida disease. One of them is conservative, the other is operational. The first option is resorted to in the initial stages of the disease. Nonsteroidal anti-inflammatory drugs are usually prescribed. In the case of disease progression, exposure to novocaine blockade and hormonal agents is required. All medicines, as well as their dosage, the doctor selects individually.
At the same time as taking medications, physiotherapeutic treatment is recommended in order to improve blood circulation in the affected area. The following procedures are characterized by particular efficiency: electromassage, mud applications, magnetic laser procedures, ultrasound, electrophoresis.
The need for surgery
Surgical treatment of Pellegrini-Stida disease of the knee joint is indicated with a decrease in the amount of motor activity in the affected limb. During the operation, the doctor removes the overgrown bone and altered cartilage. The latter is replaced by the patient's own similar elements taken from other parts of the body.
After surgery, a long rehabilitation period is required to avoid cases of relapse. The patient is prescribed hemostasis, electrophoresis with "Lidase", hydrokinesitherapy and a course of exercise therapy.
Prognosis for recovery
With timely and competent treatment, as well as compliance by the patient with therapeutic recommendations, the prognosis for recovery is favorable. After the rehabilitation period, the affected limb regains its function over time. However, the likelihood of the return of the disease is not excluded.
Prevention of cases of relapse comes down to the prevention of knee injuries, the exclusion of intense sports and physical activity. Only with this approach can a repetition of the disease or its transformation into the chronic stage be avoided.