Header: Anterior Knee Pain

Anterior Knee Pain

It is not unusual for younger people to experience pain in the knee. If the discomfort or pain persists, an early degeneration of the knee joint may be the possible cause. Moreover, if the problem remains untreated, it may lead to severe osteoarthritis at an early age.

What does "chondropatia patellae" mean?

Translated literally, the medical term chondropathia means "cartilage suffering" and patellar means“ at the kneecap." The synonym is „Patellofemoral Pain Syndrome (PFPS)" or simply "anterior knee pain". As the pain intensifies during adolescence or early adulthood, the affected person becomes very worried because he or she fears that the pain will worsen over the years and that the condition will result in early joint degeneration, namely osteoarthritis. The course of the disease is generally good. In most cases, the pain disappears spontaneously. Consequently, educating the patient about the nature of this illness is essential for a successful treatment.

What are typical symptoms of patellar chondropathia?

Pain in the kneecap is felt most often after unusual stress or strains, such as walking downhill, or even after prolonged sitting with the knees bent (cinema, car, plane).

This pain is usually felt in one knee; however, it may also be bilateral. Often the pain comes and goes for months or even years. Knee pain in the sense of chondropathic patella is more common in women than in men, especially during their teenage years or early adulthood.

What are the causes of anterior knee pain?

The causes of chondropathic patella are usually a malfunctioning of the thigh muscles and the ligaments of the knee joint. Especially a shortened thigh muscle or weakened thigh muscles on the inside of the thigh, can for example under increased stress cause pain around the kneecap.

Abnormalities or deformities of the kneecap can also promote anterior knee pain. The possible abnormalities include for example deviations in the shape and size of the patella. Deformities are usually present in a kneecap that is shifted to the outside of the knee.

Of course, symptoms may also develop as a result of overloading, overuse, accidents and injuries of the knee joint. Overloading can develop from sports with critical high proportions of jumping or straining, or even from running downhill or high-heeled shoes. In the majority of cases, however, no clear cause can be assigned to the pain syndrome in the area of the kneecap.

How is "chondropathic patella" diagnosed?

The experienced orthopedic surgeon or sports orthopedist can usually diagnose “chondropathic patella", based on the patient's complaints and a thorough medical examination. The examination, however, not restricted just to the knee joint and the kneecap, it must also include the assessment of the muscles, tendons, and ligaments responsible for the functioning of the knee joint. Important is also to assess the leg axis and the shape of the foot. In addition to the physical examination, instrumental tests to confirm the diagnosis may be useful. An X-ray study of the knee joint particularly the kneecap, shows the shape, position, and structure of the bones forming the knee joint. A magnetic resonance imaging (MRI) may also be necessary to determine the cartilage changes.

What are the treatment options of anterior knee pain?

In more severe cases of the knee joint, the joint should first be protected for a short period. Applying cooling agents, anti-inflammatory creams, ice packs or curd wraps will sooth the acute pain of the joint very effectively. The use of anti-inflammatory drugs, if at all, is only recommended short term and only in exceptionally severe cases.

Long-term treatment involves primarily physical therapy. Emphasis are here on intense stretching of the shortened hamstrings. A long-term improvement can only be achieved by targeted strength training, in particular of the inner thigh muscles. Circulation-enhancing measures such as electrotherapy, ultrasound, or ice wrap treatments (applying ice packs for 10 to 12 minutes) stimulate the metabolism and support the above-described treatment.

Injections of drugs into the joint (e.g., hyaluronic acid, homeopathic preparations) should be considered carefully, although, they might be helpful in cases of cartilage changes on the back surface of the patella, or its chondromalacia patellae in the sense of degenerative cartilage, or fibrillation.

If despite intensive physiotherapy, the knee pain persists and limits the quality of life of the patient, arthroscopic surgery should be taken into consideration. With operative procedures, the groove of the patella femur can permanently be improved so that bending the knee joint will no longer be painful. Here the joint capsule and reinforcing supporting ligaments are severed at the outside of the kneecap to lessen the tension. At the same time pain receptors at the kneecap can be isolated, and if necessary, roughened cartilage will carefully be smoothed off. The arthroscopic treatment should be followed by the type of physical therapy described above.

Specialists: Anterior Knee Pain

For an optimal treatment of anterior knee pain, the knee experts at the Klinik am Ring are particularly well-qualified. Stefan Preis, M.D. and Jörg Schroeder, M.D., senior physicians at the Practice and Department of Orthopedics and Sports Traumatology at the Klinik am Ring in Cologne, specialize together with their team in the treatment of knee and shoulder disorders. In 2004, they founded the WEST GERMAN SHOULDER KNEE & CENTER, Cologne. The team consisting of eight specialists treats more than 10,000 patients per year. Annually they perform more than 2,500 surgeries, of which about 1200 are surgeries of the knee joint.

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