Treatment of patellofemoral disorders, what is patellofemoral arthritis

Strengthen the quadriceps exercise, do the functional exercise of the knee joint, it is best to be weight-bearing, have added the strength of the knee joint and legs, and stability, plus massage, baking electricity, etc., will be effective quickly.

Patellar osteoarthritis occurs mostly between the patella and femur and is associated with overuse of the patella. It usually occurs in people who squat, bike, and climb mountains, and the patellar cartilage is damaged and then peeled off, resulting in edema and inflammation. In general, patellar osteoarthritis presents with tenderness or passive pain; Most patients will also have swelling in the patellar joint, and after the disease is severe, the cartilage will peel off, and make a sound during activity; Eventually, inflammation can lead to limited mobility.

Patellar osteoarthritis is a type of arthritis that forms between the patella and femur.

When the lateral patella is tilted or subluxated, the lateral femoral condyle trochlea is affected, resulting in excessive wear and tear of the cartilage in the lateral joint space, resulting in a series of lesions with narrowing of the joint space.

Patellar osteoarthritis is mainly an inflammation between the patella and femur. This is more common in middle-aged and older adults, especially those who enjoy sports, such as hiking, squatting in the gym, cycling. This disorder is more common in people who often enjoy squatting and standing up activities.

In particular, when the knee is extremely flexed and extended, they press the patella tightly against the trochlear of the femur, and when the knee is moved, they repeatedly flex and extend, which increases the pressure between the patella and the trochlea of the femur and exacerbates wear.

There is a thin layer of cartilage on the bones, and there is also a thin layer of cartilage on the surface of the trochlea, but the cartilage itself is difficult to regenerate, and repeated wear and tear causes the cartilage surface to fall off. When the cartilage is smoothed, bone congestion and edema occur underneath, leading to a series of inflammations.

1.Conservatism is the basic and main approach to the disease, and the following measures are commonly used. (1) Quadriceps exercises are the most common and effective methods for the prevention and treatment of patellar osteochondrosis.

By strengthening the quadriceps muscles, it can increase the stability of the joint, improve the stress distribution of the patellofemoral joint, and prevent falls or accidental injuries caused by knee pain and weakness. Common methods, such as standing piles, generally use the method of standing against a wall to avoid the angle of pain. Active straight-leg raises or weight-bearing straight-leg raises can also be done.

2) Patellofemoral joint adhesive plaster support belt or brace As an important means of conservatism, sports trauma doctors often recommend those patients who are unwilling to operate to use patellar adhesive tape or patellar brace to change the trajectory of patellar movement and contact mechanics to achieve the purpose of relieving pain and disease. (3) Intra-articular injection: Triamcinolone acetonide acetate or Corning pain injection is used once a week, which has a good short-term effect and can only be temporarily applied to athletes who need to participate in competitions. 2.

Surgery is not effective for conservative cases, and surgery may be considered in cases of severe patellar malacia. (1) Localized cartilage resection plus drilling is still the most commonly used basic operation, arthroscopy or anteromedial or anterolateral patellar incision, after exposure, the degenerated cartilage can be cut off with a planer, the subchondral bone plate is exposed, and several holes are drilled with a 1 2mm drill. The purpose of this surgery is to fill the defective cartilage with fibrogranulation tissue from the bone, and finally to form fibrocartilage.

Drilling also releases intraosseous pressure, relieving pain. (2) Patellar rearrangement surgery includes proximal and distal rearrangement surgery. Proximal realignment procedures such as lateral support band release (severing the transverse patellofemoral ligament, oblique bundle under the patella, and part of the vastus lateralis tendon), medial quadriceps cephalic transfer (fixed in the middle of the dorsal surface of the patella).

Distal realignment is mainly tibial tuberosity elevation, or elevation followed by medial eversion. (3) Patellar osteotomy can relieve intraosseous hypertension and relieve pain, and at the same time, the patellofemoral articular surface can be adjusted to make the contact more coordinated. (4) Artificial joint replacement For patients with severe patellofemoral osteoarthritis, patellofemoral artificial surface prosthesis replacement can be considered**.

5) Cartilage grafting includes autologous chondrocyte transplantation and autologous osteochondral block honeycomb grafting (also known as mosaic cartilage grafting). In the former, the patient's autologous cartilage was cultured in vitro, and the cultured chondrocytes were implanted into the lesion area by tissue engineering method, and then covered with periosteum. Autologous osteochondral block mosaic transplantation uses special instruments to chisel the osteochondral tissue in the non-weight-bearing area of the femoral condyle of the knee joint, and these columnar osteochondral blocks are transplanted to the weight-bearing area cartilage in a mosaic-like mosaic graft.

Both of these methods can be performed arthroscopically. (6) Patellectomy is only suitable for severe patients with severe pain that affects daily life.