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Patellar Chondropathy and Physiotherapy

Updated: Sep 4, 2021

Patellar Chondropathy is a common painful condition of the knees, affecting mainly the cartilage of the patella and secondarily the cartilage of the femoral pulp. The cartilage of the Tibial tubercles can not be worn because it is protected by the two Menisci, which when worn or removed lead to damage to the cartilage of the Tibial tubercles.


Epidemiology - Statistics

Patellar Chondropathy is a common painful knee condition that usually occurs in young people aged 15-40. It affects women more than men, in a ratio of 3: 1. The disease is very common even in adolescents. It is estimated that 80-85% of the population aged 20-30 have degenerative lesions and lesions of the cartilage of the patellofemoral joint. People prone to chondropathy are people who strain their knees in a kneeling position: Eg. marblers, tile technicians, plumbers, electricians, car technicians, stockbreeders, cleaners, priests, monks, etc. Gym, track athletes (jumpers, obstacles), climbers (especially downhill), waiters, dancers, people going up and down stairs, obese ladies, martial arts, truck drivers, taxis, etc. , but with pre-existing pathology of the knee, such as soft cartilage formation, anatomical lesions, structural abnormalities, etc.



Rationale
Patellar Chondropathy is due to either injury, or chronic overload of the Patellar cartilage, or to internal factors of genetic predisposition of the articular cartilage, or a combination thereof. In general, the disease is multifactorial, ie it is due to a combination of multiple causes.


Symptoms

Patellar chondropathy often presents initially with mild and vague symptoms. The main symptoms that people report are:

• sharp pain

• anterior knee pain

• heartburn

• sigh

• feeling of patella instability

• joint stiffness

• water joint (fluid concentration)

• edema


The above symptoms occur more often when climbing or descending a ladder or after a long time in a sitting position with bent knees.



Stages of the disease

Chondropathy is reported in the findings and the size of the lesion is classified into the following stages (International Cartilage Repair Society classification system):


• Normal cartilage

• First stage: the cartilage has started to soften and show superficial lesions.

• Second stage: the cartilage has started to thin and show cracks up to 50% depth.

• Third stage: the cartilage has started to thin and show cracks at a depth of more than 50%.

• Fourth stage: some parts of the patella have been stripped of cartilage and the underlying bones are exposed. The existence of osteophytes is also possible.



Physical therapy
Physiotherapy is extremely important at all stages of the condition. It is also very important for the patient's postoperative course. It is often offered at this time for many months to bring about the desired improvement.


Physiotherapy includes:

• exercises for strengthening the quadriceps femoris muscle

• strengthening of the trunk muscles

• closed quadriceps chain movement exercises, limited range of motion

• isometric contractions of quadriceps femoris muscle

• patella mobilization exercises

• special provisions

• training to adopt the right way of walking


The physiotherapy program is purchased and adapted to the individual reports of each patient. How quickly the recovery of movement will be achieved will be recognized in the patient's willingness to follow the exercise program and the advice of the treating physician.


References

1. Graham Appley and Lous Solomon: System of Orthopedics and Fractures, Churchill Livingstone Publications, 1993

2. Papadopoulos Charalambos, Gouvas Charalambos, et al: "Chondropathy of the Knee", Monograph, Sotiropoulos Publications, Athens, 1988

3. Smillie I .: "The Knee", Sawnders Publications, London, 1978

4. Weh L. & Eickhoff W., "Chondromalacia Patellae", Journal of BJD, Vol.2, 1987

5. Βandi M.:"Chondromalacia Patellae ", Helvetian Chirurgische Acta, Suppl II, 1972

6. Hille, 1984; Jager, 1983; Klems, 1979

7. Brunner B. et al.







Elpis Nicolaou , Physiotherapist {1119} Nicosia

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