Recently, Dr. Cao felt very troubled because of one thing!
What's the matter?
As long as he goes up and down the stairs, he will have pain in front of his knees, and as long as the joints are flexed to 90 degrees, he will feel a "squeaky" pain, and after this angle, it will be fine!
This has been going on for two months and there is no relief!
In dr. Cao's words, it feels a bit "a toad on the instep of the foot, not biting the diaphragm!" ”
Don't take care of it, as long as you go up and down the stairs there will be symptoms, people can't not squat up every day, take care of it, and feel that this matter is not big, there is no need to check it specially!
In the end, he still found Dr. Xie and wanted to see what his knees were up to!
In fact, this symptom is present in many people, some friends do not take this seriously, but everyone should know that this situation is likely to be your joints in the alarm to you! What should I do? Today, Dr. Xie gave everyone a good talk!
What happened to Dr. Cao?
After understanding Dr. Cao's symptoms, Dr. Xie first asked about his medical history, whether he liked sports? Have you ever suffered trauma, etc.? From his description, we know that he has been very fond of sports since he was in high school, especially basketball, and his joints are often injured.
But he felt that this symptom probably had little to do with exercise, because he had an operation two months ago, which was particularly long, about 8 hours of standing, and since then the joints have begun to have problems.
Then Dr. Xie gave Dr. Cao a physical examination, called the patella grinding experiment, this experiment is very simple, the main operation is to let the patient lie on the bed, the physical examination doctor with one hand cushioned under the knee joint, the other hand from the knee facing down to grind the patella, if it can induce obvious pain, then prove that the patient's patellar cartilage may have obvious wear.
As a result, Dr. Cao's patellar grinding test was positive.
In addition, we told Dr. Cao to lie flat, and then Dr. Xie pressed his knee joint with his hand and told him to do repeated flexion and extension movements, and we could clearly feel that when he was flexed and extended to an angle of about 80 to 90 degrees, the feeling of bone friction could be felt under the patella.
Other joint examinations, including joint stability, are negative, including the associated meniscus.
From his two positive signs of examination, we can analyze his patellar cartilage, which should be a problem.
It should be a very common problem, we call it patellar cartilage cartilage, in fact, it should be called patellar cartilage wear.
As a result, his CT examination and MRI test proved Dr. Xie's diagnosis, and from his CT examination, we saw that his patella had undergone significant outward shift, accompanied by extraversion.
What does this mean? In fact, it is very simple, under normal circumstances, when our knee joint is flexed and extended, the patella should be very smooth in a structure at the distal end of our femur called the sled, and the patella in the process of sliding, should be parallel to the structure on both sides of the sled, and should not be tilted and moved out (as shown below).
However, due to trauma, osteoarthritis, long-term strenuous exercise, congenital dysplasia and overuse, it is likely to lead to external displacement and extraversion of the patella, and the movement of the patella in the sled will lose stability, shifting to one side, which will increase the pressure between the cartilage and the displaced side and lead to wear (as shown below).
From Dr. Cao's MRI, we can also find that the problem and ct examination are mutually corroborating performance, that is, there is obvious bone edema on this side of the wear, but fortunately, the thickness of the entire cartilage is not obviously abnormal, which indicates that his problem is early.
Seeing this, I believe that everyone should also understand Dr. Cao's problem, this problem cannot be caused by standing for several hours, this is due to his long-term exercise, it may also be accumulated by many traumas.
Next, we will introduce you to the problem of patella cartilage softening in detail. Don't think this is a problem for the elderly, Dr. Cao is only 38 years old this year! Moreover, in recent years, young people with patella cartilage have also shown a trend of rejuvenation, and it is necessary for everyone to understand it.
Patelloch cartilage softening (wear)
For the patella, I believe everyone may know something, we have some people call it the knee, medically called the patella, and some areas call it belle berga.
It is the largest sesamoid bone in our human body, although it looks inconspicuous, but it has a significant role in the knee joint, if we remove the patella, the knee extension force will lose 30%!
Behind the patella of the knee is covered with an important layer of structure, which we call joint cartilage, which plays a very good role in protecting our joints, taking on pressure and impact, lubricating the joints.
So what causes wear and tear on the cartilage behind the patella to induce people to develop symptoms?
● Some friends, especially female friends, when sitting, the knee joint must be excessively flexed, which will increase the pressure between the patella and the cartilage in front of the femur in the back, and some female friends do more housework at home, often need to squat for a long time or kneel to wipe the floor, or sit on a small bench to pick vegetables, these behaviors will also increase the pressure between the patella and the posterior femur.
●People who exercise regularly are more likely to have patella cartilage, especially when the knee joint often needs to be twisted, such as playing badminton, table tennis, and basketball for a long time. Some friends often dance, such as sailor dances, ghost steps, or exercise for too long, which may also cause patella cartilage to wear out.
●Trauma, when the knee joint suffers trauma or violent injury, it may lead to damage to the cartilage behind the patella, such as some patients have a patella fracture then the cartilage behind the cartilage is damaged, it is self-evident.
●Excessive weight is also a very common cause of patella cartilage cartilage.
●Congenital dysplasia, such as knee varus or knee valgus, which is known as O-leg or X-shaped leg, is prone to osteoarticular diseases, including patelloch cartilage softening.
What are the symptoms of patellochondriasis?
In the early stages, patients often show simple discomfort or pain in the knees when going up, down stairs, or uphill or downhill, but the problem is relatively hidden, and there are no special symptoms when walking flat.
With the development of the disease, some patients will have a bouncing sound in the joints when they have pain, especially in the middle of the night, or in the case of a quiet environment, do the knee bending action, you can appear "card bar, card bar" like the sound.
The problem becomes more and more serious, patients develop obstacles to flexion and extension joints, and severe patients experience obvious pain even if they walk flat.
So when your joints have the above symptoms, especially the early up and down stairs, knee pain should not be taken lightly, this is likely to prove that the cartilage in your joints has been worn, this is the body is reminding you!
What to do?
In fact, there are too many people with such symptoms in the clinic, it is recommended that you must go to the hospital to seek the help of a doctor, conduct an MRI examination of the knee joint, we understand what kind of situation the cartilage wear in the joint is, according to the light, medium and severe degree of wear, we have different ways to deal with it.
●Patient symptoms are mild, in the case of relatively early stages, we must control our own pathogenic factors, such as reducing the use of joints, avoiding long-term sitting and squatting for a long time and other actions that increase joint pressure.
At this time, it is appropriate to take oral ammonia sugar, strengthen muscle strength training around the joint, or use external intramuscular effect patches to help us control symptoms, often achieving good results.
Studies have shown that early lesions of patellochondriasis are the only conditions within the joint that can be reversed, and if you can actively control it at this time, it is likely that the disease will not progress further.
● But if your symptoms have developed to the middle stage, the pain is very obvious, has caused a great impact on your life, then it is recommended that you can try oral ammonia sugar for about three months, you can also consider giving intra-articular injection of sodium hyaluronate or platelet-rich plasma factor, increase the elasticity of joint cartilage, control the inflammatory response within the joint, and reduce the degree of wear of joint cartilage caused by inflammation.
Of course, rehabilitation exercises at this stage, increasing the muscles around the joints and increasing the stability of the patella, are also a very important measure.
●If symptoms have been delayed to an advanced stage, patellar femoral replacement is the only solution to the problem.
summary
Through the experience of the doctor, I believe that you should have a deep understanding of this disease!
Dr. Xie's advice to Dr. Cao is to appropriately reduce the excessive movement of the joints, oral ammonia sugar, give external intramuscular effect patch treatment for a month, expect to help him better solve the problem, if the effect is not good, you can consider giving him intra-articular sodium hyaluronate treatment, which depends on the treatment effect.
We have a lot of friends around, including you who can read the article, it is likely to be a patient with patella cartilage, if you feel that this article is helpful to you, please forward this article to friends who need it or collect it yourself, when you have time, let's study together, better understand our joints, protect our joints, do you think this is OKAY?
I am Xie Xinhui who insists on explaining the knowledge of complex diseases in simple language, code words are not easy, if you agree with my point of view, please help to pay attention to or like it, thank you!