Chondromalacia patellae

When Chondromalacia patellae ( " cartilage disease of the patella " ) is a disease of the cartilage back surface of the kneecap.

Cause

With a thickness up to 7 mm, the cartilage on the patella of the thickest of the human body. The nutrition of the cartilage takes place via a process Walk, and the inside - out and presses the synovial fluid into the cartilage again. Walk This process can take place reliably only in a fairly narrow pressure range. If the pressure is too high, the process is just as disturbed as pressure is too low.

The main extensor muscle of the knee, the quadriceps femoris, is very sensitive to inactivity or sparing of the leg. Within less than two weeks lost the central head of this muscle, a large part of his force. The resultant force acting on the upper pole of the patella, shifted, and with it the load distribution in the knee cap sliding bearings. Regardless of the actual disease can therefore lead to damage to the patella back face of each "bad condition " of a knee. This disease can become independent and even after the first disease is cured, continue to exist. The resulting nutritional disorders lead to a degeneration of the cartilage, the surface is rough, the fibers become evident, one speaks of the "Fall of the cartilage ."

Symptoms

In milder cases, the Walking prepares in the plane no difficulty, pain often occurs when walking downhill, when squatting and sitting for long periods. Hence the popular name "Theatre knee," people started after the first act to scratch with their feet.

Course

The disease sometimes occurs even in children or young people fairly. Girls and women are affected slightly more often. The disease leads, untreated, to a progressive degeneration of cartilage. At the end, the osteoarthritis of the knee cap sliding bearing.

Diagnostics

If you look at a diseased leg at first falls on the weak or frail central head of the thigh extensor. The movement test shows crepitus in the sliding bearing, the doctor may trigger certain phenomena, all of which demonstrate the irritation of the patella sliding bearing. Stimulus bruising or capsule swelling may occur, but are not necessarily available. There is a special X-ray technique in which the sliding bearing is shown in different functional states, the explanatory power is limited. The NMR shows in a later stage, the cartilage damage at the onset of the disease but no pathological findings will be charged here.

The image shows a cross section through the bone of the thigh, the femoral condyles. In the upper part of the image is the kneecap. Good for the representation comes the fine structure of the bone, called cancellous bone.

Between the patella and the femur, the cartilage layer is to be seen, the fine, gray seam between the synovial fluid. In the lower part of the picture is the back of the knee with the passing vessels. The joint capsule surrounds the thigh and the kneecap, one sees indicated the fiber structure. The honeycombed, brightly illustrated material is body fat.

Therapy

A leg as well as getting injured, it should be operated in order to obtain the force of the thigh as early as possible just specific exercises. This represents the reasonable treatment of Chondromalacia patellae, build up the thigh about physiotherapy or electrical stimulation. The industry has a series of " engine ", which but for non-critical use, do more harm than good. There are various bandages to improve the guidance of the patella in the movement.

The aim of physiotherapy measures, on the one hand to strengthen the thigh extensor. It can also be reduced through specific stretching of the thigh extensor pressure on the kneecap, so that is positively influenced as a result of disease progression.

In addition to these therapeutic approaches, there are several surgical options to change the kneecap sliding bearings. This can be a splitting of the capsule system, a fettering of the quadriceps tendon, which can also be an operational displacement of the patellar tendon on the tibia head. However, a surgical procedure is useful only if the other treatment measures fail and the cause is due to an excess pressure of the patella.

The selection of the appropriate therapeutic procedure depends both on the type of damage, but also the way of life of the patient and of the claims that he has to his physical performance, from.

• Disease in orthopedic and trauma surgery
• Kneecap