The diagnosis begins with an inquiry of the exact symptoms and a physical examination. Typical starting pain or pain when going downhill already indicate a cartilage damage behind the kneecap. Although the arthrosis cannot be detected with an ultrasound examination, potential joint effusions can already be detected and punctured if necessary.
If the suspicion of arthrosis behind the patella is confirmed, radiological images such as X-rays and MRI images should be taken. The structures of the bones of the knee joint and the shape of the patella can be clearly seen in the X-ray. Conventional knee arthrosis can already be guessed at by narrowing the joint space.
The ligaments and cartilage can be better visualized in the MRT. In order to clearly see the cartilage damage, a joint endoscopy can be performed. However, it is an invasive procedure with risks and should only be used if there is a possibility of treatment and alleviation of the arthrosis through knee endoscopy.
With special techniques, the kneecap can also be shown well on X-rays. The image is taken horizontally and in different flexions of the knee in order to be able to see the kneecap in its sliding bearing and to be able to follow its movement in different stretches and flexions of the joint. This also allows statements to be made about the structure of the back surface of the kneecap.
Advanced arthroses behind the patella can be clearly identified in this way. In order to be able to make statements in the early stages, however, an MRI of the knee must often still be carried out. Magnetic resonance imaging is a radiation-free and high-resolution imaging technique, which is, however, more complex and involves higher costs.
MRI allows high-resolution imaging of soft tissue in particular. For example, MRI of the knee is used for all cartilage, ligament and tendon injuries to obtain high-resolution images of the inside of the knee. Inflammatory changes in the cartilage, joint effusions, cartilage damage and pieces of cartilage floating freely in the joint can also be excellently diagnosed by MRI.
Training and Sport
The practice of sport must be carefully considered in the case of arthrosis behind the kneecap. Intensive exercise often intensifies the symptoms and the clinical picture, whereas light physiotherapeutic training sessions can have a therapeutic effect on the arthrosis. For older patients, specific joint-sparing courses can be taken which concentrate on stretching exercises, maintaining movement and strengthening the stabilising muscles.
Fitness studios are also frequently subsidized by health insurance companies for patients of all ages. It is important, however, that training is supervised by experienced doctors or physiotherapists in order not to put the wrong strain on the joint. A frequent relieving exercise for the arthrosis behind the kneecap are rocking exercises.
Here, the affected person sits on a chair and straightens his or her feet on tiptoe. He then seesaws the foot until the feet rest on the heel. This bouncing can be done for a few minutes at a time.
Also while sitting, an object of different weight can then be grasped on the floor from both sides with the feet and then lifted by stretching the knees. In this way the leg extenders are strengthened. Light movement exercises can also be performed in bed before going to sleep.
To do this, the legs can be moved through as when cycling or simply bent and stretched alternately. Holding the legs in the air can also be a good exercise for the leg muscles. To strengthen the rear leg muscles, the same exercises can be performed lying on the stomach.