How to identify patellomalacia?

How to identify patellomalacia?   Patellar softening usually occurs in young adults, and there is a history of obvious trauma, or there are chronic cumulative small injuries. The main symptom is pain behind the patella of the knee joint.

Direct knee trauma can cause patellar cartilage or osteochondral fractures, or due to multiple injuries, such as sports injuries, cartilage degeneration changes, cartilage surface roughness, loss of luster, cartilage loss in severe cases, bone exposure, and its relative femoral joints The face was also damaged. The injury site is mostly in the center of the patella.

Do some rehabilitation training, more exercise will be better, the symptoms will gradually alleviate. This disease mostly occurs in young adults with a history of obvious trauma or chronic accumulation of small injuries. The main symptoms are pain behind the patella of the knee joint, with varying degrees of severity. Generally, the symptoms of walking on flat ground are not obvious. Pain worsens after going up and down, or walking a long way.

Patellar softening diagnosis table

1. Patella compression test: During the inspection, the patella and its opposing femoral intercondylar articular surface are squeezed and ground or slid up and down, left and right, there will be rough friction, friction and pain and discomfort; or the examiner will force the patella to one side. On the side, pressing the back of the edge of the patella with the thumb of the other hand can cause pain.

2. One-leg squat test: The patient holds a weight on one leg, and gradually squats down to 90°～135°, and the patient feels pain and softness. After squatting, one leg cannot stand up.

3. X-ray examination: according to the knee joint frontal, lateral and tangential patella X-rays, there is no abnormality in the early stage, and the late stage may be due to most of the cartilage wear, the gap between the patella and the femoral condyle becomes narrow, and the edges of the patella and femoral condyle There may be bone hyperplasia. The main basis for the diagnosis of patellomalacia is the pain behind the patella, which is caused by the patellar compression test and the single-leg squat test. Attention should be paid to check for meniscus injury and traumatic arthritis.

Symptoms of patellar cartilage softening

Pain: Mild, it hurts only when going up and down the stairs. It is possible that the knee joint may suddenly become weak. Sometimes it hurts when half squatting exerts strength, such as from squatting to standing, especially when lifting heavy objects. Severe activities of daily life will cause pain. When walking, the knee joint may have soft legs. In addition, if you massage the edge of the patella with your hands, there is often obvious tenderness.

Sound: When the knee joint is flexed and extended, there will often be noises under the patella. In severe cases, if you sit and straighten your legs, put your hands on the patella and rub against the patella, you can hear the “rustling” sound. It’s like sand in the joints.

Swelling: Because of the inflammation inside the joint, the synovial membrane of the joint secretes a lot of fluid, so the knee joint is swollen.

Thinness: The softening of the patella will cause the quadriceps muscle to atrophy and become weak, so the appearance of the thighs will become thinner.

Precautions

1. Actively and fully move the joints under the condition of not bearing weight, such as lying on the bed actively extending and flexing the knee joints, insisting on once a day in the morning and evening, each time for 10 minutes.

2. Prevent continuous pressure on the articular surface of the patella. The patella at the knee flexion position is subject to greater pressure and is easy to damage the articular surface. Avoid continuous squatting pressure on the articular surface of the patella.

3. During plaster fixation or lower extremity traction treatment, the quadriceps should be exercised actively, which can drive the patella to move up and down when the quadriceps relaxes and contracts.

4. Do not wear high heels. When walking or running, wear shoes that help maintain your body’s balance and balance.

5. Prevent continuous compression of the articular surface of the patella. The patella at the knee flexion position is subject to greater pressure, which is easy to damage the articular surface.

(source:internet, reference only)

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