Many people suffer from osteoarthritis of the kneecap as they age. It is a progressive process in which the articular cartilage behind the kneecap is damaged and then broken down. The impairments caused by this can be considerable, especially if the course is not age-appropriate.
What is kneecap arthrosis?
The first symptoms that could indicate osteoarthritis of the kneecap are often presented as a crunching noise when walking down a flight of stairs. The same phenomenon can also be seen when standing up after sitting for a long time.
Osteoarthritis of the kneecap is wear and tear on 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. See AbbreviationFinder for abbreviations related to Kneecap Arthrosis.
The body’s own production process for producing synovial fluid decreases to such an extent that the cartilage layer behind the kneecap becomes narrower and more brittle. The elasticity of the cartilage tissue is increasingly lost. The patient experiences pain that increases over time. The knee joint becomes increasingly stiff, which ultimately means that pain-free everyday mobility is no longer possible.
Since the cartilage tissue is not supplied with blood, the treatment options are considered to be limited. It is therefore all the more important to reduce or eliminate existing risk factors as far as possible.
Causes
The causes of kneecap arthrosis (retropatellar arthrosis) can be different. The trigger for the wear and tear of the cartilage behind the kneecap can be a hereditary reduction in the quality of the cartilage. The lateral ligaments of the kneecap can also be too short and cause a slight change in 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 (tilers), overweight or due to congenital leg malpositions. This creates too much pressure between the kneecap and the femur, which promotes wear and tear on the cartilage surface. Osteoarthritis of the kneecap can also be caused by a hereditary deformity of the kneecap.
A fracture of the kneecap or lateralization of the patella can also be responsible for the development of the disease. This means a functional disorder of the kneecap in connection with a disturbed use of the slideway. Treatment errors in meniscus or cruciate ligament injuries can cause a deficit in the necessary stabilization function related to the knee joint.
In the long term, this can trigger arthrosis in this affected area. Ultimately, arthrosis of the kneecap can also occur as a result of inflammation of the knee joint.
Symptoms, Ailments & Signs
The first symptoms that could indicate osteoarthritis of the kneecap are often presented as crunching noises when walking down stairs. The same phenomenon can also occur when getting up after sitting for a long time. If additional pain occurs during this movement, osteoarthritis of the kneecap is the likely cause.
Another sign of arthrosis is an increase in the sensitivity to pain when subjected to additional loads (exertion pain). If special sensitivities occur in wet and cold weather, this also indicates the presence of osteoarthritis of the kneecap. The increased occurrence of pain at the beginning of movements or loads is also symptomatic.
After a while, the pain will subside again. This typical course of arthrosis is also referred to as start -up pain. Over time, the pain intensifies and the restriction of movement increases. Finally, the knee joint stiffens.
Diagnosis & course of disease
The diagnosis includes a thorough physical examination and an extensive questioning of the patient to find out a possible history of the disease. Among other things, obesity and possible misalignments of the legs are taken into account. In addition, the movement of the patella is assessed, especially with regard to possible displacement in the plain bearing.
Imaging methods such as ultrasound examinations and X-rays help to clarify the situation further. In individual cases, magnetic resonance imaging may also be necessary. A laboratory test can also be carried out to rule out possible bacterial infections or rheumatic causes. If osteoarthritis of the kneecap is diagnosed, therapy should be started immediately because of the progressive course.
Otherwise, after the initial symptoms, the pain and restricted movement will increase unchecked. Without therapy, the affected person would have to deal with fatal consequences both personally and professionally. In many cases, without professional treatment, the only option is surgery.
Complications
In most cases, kneecap arthrosis occurs primarily in older patients. It can lead to various limitations and complaints and significantly reduce the quality of life of those affected. In most cases, there is difficulty or pain in ordinary activities in everyday life. Climbing a flight of stairs is associated with pain for the person concerned.
This can occur under stress or in the form of pain at rest. Pain at night can also lead to trouble sleeping. It is not uncommon for this to lead to restricted movement, so that the patient may be dependent on the help of other people in everyday life. Furthermore, kneecap arthrosis can also lead to psychological problems or depression and thus make everyday life of those affected significantly more difficult.
Osteoarthritis of the kneecap can be treated relatively well with the help of cortisone. This is injected directly into the patient’s knee. The symptoms usually disappear after the treatment. This may need to be repeated if the pain recurs. There are no other complications. Life expectancy is also usually not reduced by osteoarthritis of the kneecap.
When should you go to the doctor?
Patients with kneecap arthrosis often have so-called anterior knee pain. This pain occurs mainly during physical exertion, for example when standing up or going down stairs. There is often a clear crunching noise when moving, which is reminiscent of a coffee grinder. In some cases, the entire knee appears blocked. Then the affected leg can only be moved to a limited extent or not at all. Inflammatory arthrosis of the kneecap is manifested by a noticeable overheating and swelling in the area of the knee. The symptoms mentioned can vary depending on the stage at which the arthrosis is located.
In the first stage, there is slight pain and occasional blockages. In the second stage, the arthrosis intensifies and increasingly burdens the affected person with physical activities. In the third stage, the affected leg can no longer be moved without pain. The kneecap becomes inflamed again and again, which can result in nerve pain and functional disorders of the leg. In the final stage, osteoarthritis of the kneecap has affected the entire joint. The pain is permanent and the patient suffers from numerous side effects, such as cramps, joint wear and tear and malpositions. This results in irritability, personality changes, depressive moods and other mental illnesses.
Treatment & Therapy
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 the pain is present, treatment with painkillers is possible first. These also have an anti-inflammatory effect. In the case of severe pain and already pronounced movement restrictions, cortisone can also be injected directly into the affected knee.
However, a cure cannot be achieved in this way. Due to the well-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 movement. If the destruction of the cartilage mass has already progressed too far, surgical measures can be taken as a last resort.
In addition to the findings from the imaging examination methods, a joint reflection (arthroscopy) is also carried out to precisely determine the clinical picture. Already damaged tissue can be removed and cartilage smoothing can be carried out. Depending on the findings, a kneecap, a complete knee joint or certain parts of the joint can be implanted. The upper layer of bone can also be scraped off to stimulate the body’s own defense function. This causes bleeding.
This is intended to initiate an increased immune system response to repair the affected area. Arthrosis-friendly everyday behavior can prevent unnecessary further cartilage damage. A change in diet is also an option for the holistic therapy of arthrosis. Reducing body weight in the case of obesity also promises to reduce impairments.
Outlook & Forecast
The prognosis of kneecap arthrosis is unfavorable. It is a chronic disease with a progressive course. If no further medical care is sought, an increase in the symptoms is to be expected. The cartilage tissue is not supplied with sufficient blood and is ultimately continuously removed. This leads to a restriction of movement of the knee. In addition, the physical resilience of those affected decreases and the quality of life dwindles.
In one treatment, the progression of the disease is delayed by various measures. Pain is alleviated by the administration of medication and a change in the general movement sequences can be trained through targeted training. However, healing cannot be achieved in this way. In an advanced stage of the disease and after all other treatment options have been exhausted, surgical intervention is carried out. 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 in patients who are old or in a weakened state of health. Although a reduction in symptoms is achieved through this procedure, a lower general resilience is to be expected. Professional or sporting activities may need to be restructured. Without an implant, the affected person is dependent on walking aids or a wheelchair.
Prevention
A number of things can be done to prevent kneecap arthrosis with a view to the causes of its development. Knee pads offer protection in the case of permanent overloading due to frequent kneeling, as is the case with tilers. 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 overuse is also helpful. Being overweight is also an avoidable burden. In addition, a balanced diet rich in vital substances in connection with the practice of gentle sports forms an advantageous framework for preventing osteoarthritis of the kneecap.
Aftercare
According to current scientific knowledge, osteoarthritis of the kneecap cannot be cured. It is chronic; an increase in complaints is to be expected if the signs are ignored. Therefore, follow-up care cannot aim to prevent recurrence. Instead, it aims to avoid complications and strengthen the patient’s everyday life in the form of long-term treatment.
Depending on the intensity of the symptoms, the doctor treating the patient arranges regular examinations with his patient. 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 arthrosis. Alleviating 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 physical therapist can initially suggest appropriate workouts.
Cycling is considered useful because the joint is moved without much stress. But everyday professional life also needs to be reflected upon. Some osteoarthritis of the kneecap arises from overuse in physically demanding jobs. Patients achieve relief from signs with knee pads and proper lifting and carrying techniques.
You can do that yourself
If osteoarthritis of the kneecap is diagnosed, it is helpful to check everyday life and reorganize it if necessary. Lifting and moving heavy loads, for example, can be one of those tasks that ideally can be outsourced or organized in some other way. This is especially true when stairs have to be overcome. Work that has to be carried out in a bent or kneeling position should also be delegated to other people if possible. Additional weight and pressure on the affected kneecap not only causes pain, but can also accelerate wear and tear, making the overall situation worse. The rule of thumb is: As soon as pain occurs, you should take care 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 down. The affected person can contribute a lot to the preservation of the cartilage mass through targeted nutrition, often by changing the dietary habits of years. First and foremost, it is important to completely avoid certain foods, for example fatty red meat, as well as an excess of meat in general. When using oils, you should switch to cold-pressed oils such as olive oil. Generally, ready meals should be avoided.
Other foods, on the other hand, should be consumed preferentially: millet promotes cartilage regeneration, lots of vegetables and fruit are also beneficial. In any case, the patient should ensure a healthy and balanced diet in order to avoid an unbalanced diet. Dietary supplements can have a positive effect on the transition.
