Cartilage damage behind the kneecap due to sports | Cartilage damage behind the kneecap

Cartilage damage behind the kneecap due to sports

In connection with sports, cartilage damage behind the kneecap occurs as a result of incorrect or excessive strain as well as sports accidents. Since the knee joint is put under a great deal of stress in many sports, such as soccer, skiing and jogging, incorrect posture has a very strong effect here. The cartilage surfaces of the bones then rub against each other more and more and wear out. The development of cartilage damage is promoted by congenital defective positions of the legs, such as knock-knees, and by overweight. Previous injuries to the knee joint, such as torn cruciate ligaments or meniscus damage, can also place increased stress on the cartilage behind the kneecap, which leads to increased wear and tear.

Symptoms

Characteristic pain for the cartilage damage behind the patella is a dull, difficult to localize pain which is described by the affected persons as pain “in” the knee joint as well as “behind”, “around” or “under” the patella. An increase in pain sensation occurs during sports activities such as jogging, jumping, but also during everyday movements such as climbing stairs or sitting and squatting for long periods of time. The symptoms are usually described as chronic pain, although it can also be due to a specific injury.

The symptoms can occur on one side or both sides.Swelling of the knee is not a typical sign of this cartilage damage, although some sufferers describe a certain “stiffness” in the knee joint. A “jumping out” or “cracking” feeling is also often described. If loose pieces of cartilage are also present, movement may be restricted and be symptomatic.

The diagnosis of cartilage damage behind the kneecap can sometimes be difficult. It is not always easy to assess whether the knee joint is damaged or whether the cartilage behind the kneecap is affected. This can be done primarily by a detailed anamnesis (medical history) and by further movement tests, which can detect a restriction of the joint under certain circumstances.

For example, there is often a pressure pain in the area of the patella (kneecap) as well as an effusion, which can be determined by specific orthopedic tests. Although imaging procedures are relatively well suited for diagnosis, i.e. the presence of cartilage damage behind the patella, they are also well suited to exclude other diseases with similar symptoms. In rare cases, it may be necessary to perform a knee arthroscopy to exclude other diseases.

The two most important imaging procedures to make a diagnosis are: The X-ray image shows bony changes that indicate the degree of arthrosis of the kneecap. The damage to the cartilage cannot be assessed directly. Nevertheless, the X-ray image is a valuable diagnostic tool for assessing the structure of the knee joint and patella.

The MRI of the knee can particularly well show the actual cartilage damage in the knee joint. The extent of the cartilage damage can be determined exactly, since the cartilage behind the kneecap is particularly thick. The MRI divides cartilage damage into four degrees of severity.

  • The X-ray image (X-ray knee in 3 planes) and
  • The MRI of the knee

Cartilage damage behind the kneecap is classified into different degrees of severity, depending on the surface of the cartilage and the depth of the damage. Depending on the degree of severity, different therapeutic approaches are used. Since the pain in the knee usually occurs only after the cartilage has already been destroyed, conservative therapy is often no longer possible.

Once cartilage is worn out, it does not regenerate.

  • With a grade 1 cartilage damage, the cartilage surface is still intact, but may contain softening (chondromalacia).
  • From grade 2 on, cracks in the cartilage are added, which are as long as half of the cartilage thickness. In the first two stages, cartilage damage is often not noticeable at all or only slightly.
  • From a damage of grade 3 on, the affected persons usually have stress pain.

    Here, the cartilage damage usually reaches the bone.

  • With a cartilage damage grade 4 there is nothing left of the cartilage. It is completely worn out and the bone is exposed. This is called cartilage baldness.