Numerous people will suffer from one throughout their lives as they age Kneecap arthrosis. It is a progressive process that damages and, as a result, breaks down the articular cartilage behind the kneecap. The impairments caused by this can be considerable, especially if the course is not age-appropriate.
What is kneecap arthrosis?
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In the Kneecap arthrosis it concerns signs of wear and tear of the cartilage behind the kneecap. In addition to the aging process, this development can accelerate for various reasons. The cartilage becomes increasingly rough and cracked. The constantly necessary supply of nutrients to the cartilage tissue to ensure the healthy functionality of the knee joint is impaired.
The body's own production process for producing synovial fluid decreases so much that the cartilage layer behind the kneecap becomes narrower and more fragile. The elasticity of the cartilage tissue is increasingly lost. This results in pain for the person affected, which increases over time. The knee joint becomes more and more rigid, which ultimately means that pain-free everyday mobility is no longer possible.
Since the cartilage tissue is not supplied with blood, the therapy options are considered to be limited. It is therefore all the more important to reduce or eliminate existing risk factors as much as possible.
causes
The causes of kneecap arthrosis (Retropatellar arthrosis) can be different. A hereditary reduction in the quality of the cartilage can be the trigger for the wear and tear of the cartilage behind the kneecap. Due to the nature of the situation, the lateral straps of the kneecap may be too short and cause a slight change in the position of the kneecap (patella).
Excessive wear and tear in the kneecap joint (femoropatellar joint) can also be caused by heavy loads such as heavy carrying, frequent kneeling (tiling), overweight or congenital leg deformities. This creates too much pressure on the kneecap on the thigh bone, which promotes wear and tear on the cartilage surface. Kneecap arthrosis can also be caused by a hereditary malformation of the kneecap.
A fracture of the kneecap or patellar lateralization can also be responsible for the development of the disease. This refers to a malfunction of the kneecap in connection with impaired use of the slideway. Treatment errors in meniscus or cruciate ligament injuries can lead to a deficit in the necessary stabilization function in relation to the knee joint.
This can cause osteoarthritis in this affected area in the long term. Ultimately, osteoarthritis of the kneecap can also occur as a result of inflammation of the knee joint.
Symptoms, ailments & signs
The first symptoms that could indicate an osteoarthritis of the kneecap often appear as grinding noises when walking down stairs. The same phenomenon can also appear when standing up after sitting for a long time. If additional pain occurs during this movement, kneecap arthrosis is the likely cause.
Another sign of osteoarthritis is an increase in pain sensation with additional loads (exertion pain). If there are particular sensitivities in wet and cold weather, this also indicates the presence of kneecap arthrosis. The increased occurrence of pain at the beginning of movements or loads is also symptomatic.
After a while the pain will decrease again. This typical course of osteoarthritis is also referred to as starting pain. Over time, the pain intensifies and the movement restrictions increase. Eventually the knee joint stiffens.
Diagnosis & course of disease
At the beginning of the diagnosis, a thorough physical examination and extensive questioning of the patient are included in order to find out a possible medical history. Among other things, attention is paid to obesity and possible misalignments of the legs. In addition, the movement of the patella is assessed, especially with regard to a possible displacement in the slide bearing.
Imaging procedures such as ultrasound examinations and x-rays help to clarify this further. Magnetic resonance imaging may also be necessary in individual cases. A laboratory test can also be performed to rule out possible bacterial infections or rheumatic causes. If kneecap arthrosis is detected, therapy should be started immediately because of the progressive course.
After the initial symptoms, the pain and movement restrictions increase unchecked. Without therapy, the person affected would have to deal with personally and professionally fatal effects. In many cases, surgery is the only option without proper treatment.
Complications
In most cases, osteoarthritis of the kneecap occurs primarily in the elderly of the patient. It can lead to various restrictions and complaints and significantly reduce the quality of life of the person affected. In most cases, there is difficulty or pain in ordinary everyday activities. Thus, climbing stairs is associated with pain for the person concerned.
These can occur under stress or in the form of pain at rest. Pain at rest at night can also lead to sleep problems. It is not uncommon for this to restrict movement, so that the patient may be dependent on the help of other people in everyday life. In addition, osteoarthritis of the kneecap can also lead to psychological complaints or depression and thus make everyday life much more difficult for the person affected.
Kneecap arthrosis can be treated relatively well with the help of cortisone. This is injected directly into the knee of the affected person. The symptoms usually go away after treatment. This may have to be repeated again if the pain occurs again. There are no further complications. Kneecap arthrosis does not usually reduce life expectancy either.
When should you go to the doctor?
Patients with osteoarthritis of the kneecap often experience what is known as anterior knee pain. This pain occurs mainly during physical exertion, for example when getting up or climbing down stairs. There is often a noticeable crunch when moving, reminiscent of a coffee grinder. In individual cases the entire knee appears blocked. Then the affected leg can only be moved to a limited extent or not at all. Inflammatory osteoarthritis of the kneecap manifests itself as a noticeable overheating and swelling in the knee area. The symptoms mentioned can vary in severity depending on the stage in which the osteoarthritis is.
In the first stage there is slight pain and occasional blockages. In the second stage, the osteoarthritis intensifies and the person concerned is increasingly stressed during physical activities. In the third stage, the affected leg can no longer be moved painlessly. The kneecap becomes inflamed again and again, which can result in nerve pain and functional disorders of the leg. In the final stage, the kneecap arthrosis affected the entire joint. The pain persists and the patient suffers from numerous accompanying symptoms, for example cramps, joint wear and misalignment. This results in irritability, personality changes, depressive moods and other mental illnesses.
Therapy & Treatment
The cartilage mass that is not supplied with blood cannot be healed after damage. Only a delay in the development of the disease and an alleviation of the symptoms can be achieved. If pain is present, treatment with painkillers is possible first. These also have an anti-inflammatory effect. Cortisone can also be injected directly into the affected knee in the case of severe pain and pronounced restrictions on movement.
However, a cure cannot be achieved through this. Due to the known side effects of cortisone, long-term treatment with this active ingredient should be avoided. An injection of hyaluronic acid into the knee joint to slow down the development of the disease and to relieve symptoms is more appropriate. It is also helpful to strengthen the thigh muscles to relieve the strain during movement. If the destruction of the cartilage mass has progressed too far, surgical measures can be taken as a last resort.
In order to precisely determine the clinical picture, in addition to the findings from the imaging examination methods, an arthroscopy is also carried out. Damaged tissue can be removed and cartilage smoothing can be carried out. Depending on the findings, an implantation of a kneecap, a complete knee joint or certain joint parts can be carried out. The upper bone layer can also be scraped off to stimulate the body's own defense function. This creates a bleeding.
This is intended to initiate an intensified reaction of the immune system for repair in the affected area. Everyday behavior suitable for osteoarthritis can prevent unnecessary further cartilage damage. A change in diet is also an option for holistic therapy of osteoarthritis. The reduction of body weight in the case of obesity also promises to reduce the impairments.
Outlook & forecast
The prognosis for an osteoarthritis of the kneecap is unfavorable. It is a chronic disease with a progressive course. If no further medical care is used, an increase in the symptoms can be expected. The cartilage tissue is not supplied with sufficient blood and is ultimately continuously removed. This restricts the movement of the knee. In addition, the physical resilience of the person concerned decreases and the quality of life dwindles.
In one treatment, various measures are used to delay the progression of the disease. Pain is relieved by the administration of medication and through targeted training a change in general movement sequences can be trained. However, healing is not achieved in this way. At an advanced stage of the disease and after all other therapy options have been exhausted, an operation is required. The knee joint is exchanged and replaced with an implant. The surgery is associated with various risks and side effects. In addition, the healing and recovery path takes several months.
Interventions are particularly difficult for patients of old age or when the person concerned is in poor health. Although a reduction in symptoms is achieved through this procedure, a lower general resilience can be expected. Professional or sporting activities may need to be restructured. Without an implant, the person affected is dependent on walking aids or a wheelchair.
prevention
To prevent kneecap arthrosis, a lot can be done with a view to the causes. In the case of permanent overload due to frequent kneeling, such as with tilers, protection with knee pads is recommended. Carrying heavy loads, like many athletic movements, can be learned to avoid putting undue pressure on the knee.
Strengthening the thigh muscles to reduce the effects of overload is also helpful. Overweight is also an avoidable burden. In addition, a balanced diet rich in vital substances in connection with the exercise of gentle types of sport form an advantageous framework for preventing kneecap arthrosis.
Aftercare
Kneecap arthrosis is not curable according to current scientific knowledge. It is chronic; an increase in complaints is to be expected if the signs are not observed. Follow-up care cannot therefore aim to prevent recurrence. Instead, in the form of long-term treatment, it aims to avoid complications and strengthen the patient's everyday life.
The attending physician arranges regular examinations with his patient depending on the severity of the complaint. The current status is recorded in these. Imaging methods such as x-rays and ultrasound images allow conclusions to be drawn about the progression of the osteoarthritis. Relieving the signs is not just the doctor's responsibility; rather, the patient must also become active.
The latter can contribute a lot to a symptom-free life. It has been proven that strengthening the muscles leads to a reduction in symptoms. Daily exercises should definitely be done at home. A physiotherapist can initially suggest suitable training sessions.
Cycling is considered sensible because the joint is moved without great stress. But everyday professional life must also be reflected on. Some kneecap arthrosis result from overstrain in physically demanding jobs. Patients will find relief from symptoms with knee pads and proper lifting and carrying techniques.
You can do that yourself
If kneecap arthrosis is diagnosed, it is helpful to check everyday life and, if necessary, reorganize it. Lifting and moving heavy loads, for example, can be one of those tasks that can ideally be outsourced or otherwise organized. This is especially true when stairs have to be overcome. Work that has to be performed in a stooped or kneeling position should also be delegated to other people if possible. Additional weight and additional pressure on the affected kneecap not only leads to pain, but can also accelerate wear and tear and thus worsen the overall situation. As a rule of thumb: As soon as pain occurs, care should be taken to rest.
Osteoarthritis is fundamentally irreparable, since damage to the cartilage has already occurred, but this cartilage does not heal or regenerate itself. However, the progression of the disease can be stopped or slowed. The person affected can contribute a lot to maintaining the cartilage mass through targeted nutrition, often by changing the eating habits that have existed for years. The main thing is to avoid certain foods altogether, for example fatty red meat, and generally an excess of meat. When using oils, you should switch to cold-pressed oils such as olive oil. Ready meals are to be avoided in principle.
Other foods, on the other hand, should be preferred: Millet promotes cartilage regeneration, lots of vegetables and fruits are also beneficial. In any case, the patient should ensure a healthy and balanced balance in order to avoid a one-sided diet. Dietary supplements can have a positive effect on the changeover.
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