How long does it take to treat patellar chondromalacia? What are the treatments?

Patellar softening is a disease that has a great impact on people. Once you suffer from patellar softening and do not receive timely treatment, it is likely that you will not be able to walk normally. The treatment of patellar softening is generally divided into three stages, and each stage requires corresponding treatment. The treatments for patellar softening are mainly divided into traditional Chinese medicine and surgical treatment. Below, we will introduce you to the relevant knowledge about the treatment of patellar softening!

Three-stage treatment of chondromalacia patella

Stage 1: For patients with chondromalacia patella, the first thing to do is to understand whether there is fluid accumulation in the knee joint. If there is fluid in the knee, you should first undergo three weeks of treatment to eliminate the fluid, which can be done with physical therapy and medications such as diclofenac. Please note that during the three-week treatment period to eliminate the effusion, you must reduce your activities. If the amount of activity is not reduced enough, simply taking oral medications such as Voltaren may not result in satisfactory elimination of the effusion after three weeks. If there is no fluid accumulation in the joint, you can proceed directly to the second stage of drug treatment below.

The second stage: Wait until the effusion is effectively eliminated in three weeks before starting this stage of treatment, which involves 5 weeks of oral glucosamine sulfate medication and intra-articular injection of sodium hyaluronate, once a week for a total of 5 weeks. This is generally known by local orthopedic doctors. However, if the joint effusion does not subside, it will affect the effectiveness of these two drugs.

Phase 3: After completing the five-week drug treatment in Phase 2, follow the methods on this website and perform the "static quadriceps exercise method" to thicken your thighs. This will not only allow you to resume your previous activities, but also reduce future recurrences.

Acupuncture and moxibustion in traditional Chinese medicine for chondromalacia patella

1. Standard location: On the inner side of the calf, below and posterior to the medial condyle of the tibia, 1 inch behind Yinlingquan, and above the medial head of the gastrocnemius.

2. Method: Bend your knees, first find the Yinlingquan point at the lower edge of the medial condyle of the tibia, and then find the point 1 inch behind it.

3. Acupoint anatomy: Below the acupoint are the skin, subcutaneous tissue, sartorius muscle (tendon), semimembranosus muscle and semitendinosus muscle (tendon). The skin is supplied by the saphenous nerve. The sartorius muscle originates from the anterior superior iliac spine, the semitendinosus and semimembranosus muscles originate from the ischial tuberosity, and the three muscles insert on the medial side of the tibial tuberosity. The sartorius muscle is innervated by the femoral nerve, and the posterior two muscles are innervated by the sciatic nerve. The needle passes through the skin, subcutaneous fascia, behind the great saphenous vein, through the deep tendons of the calf, and directly reaches the insertion tendons of the above-mentioned muscles and the tibial periosteum. The internal popliteal artery originates from the groin artery and flows downward from the fossa to the knee joint network.

4. Function: Dispel wind and dampness, and dredge joints.

5. Main diseases treated: gout, patellar chondromalacia, suprapatellar bursitis, rheumatism and rheumatoid arthritis. Needling method: straight needle: 0.8-1.0, local soreness and swelling, with numbness and electric sensation radiating to the sole of the foot. Moxibustion method: moxibustion with moxa cones or warm needles 3-5 times, moxibustion with moxa sticks for 10-20 minutes.

Western medicine treatment of patellar chondromalacia - surgical treatment

Surgical treatment: Patients with severe symptoms should undergo surgery in a timely manner and receive appropriate treatment based on the severity of the patellar lesions.

1. Patellar cartilage removal: including superficial cartilage cutting, cutting cartilage to reach bone and bone drilling.

(1) Superficial cutting of cartilage: Use a sharp knife to cut the degenerated cartilage until the normal part of the cartilage. Although the cartilage repair ability is very weak after shallow cutting, after the eroded cartilage is removed, the surface becomes smooth and covered with several layers of flat cells after several months of shaping, making the operation achieve more satisfactory results.

(2) Cutting cartilage to bone: If the cartilage damage has reached the bone, the entire layer of cartilage can be cut and the wound edge can be trimmed to form a bevel, leaving the exposed bone untreated. Full-thickness cartilage defects that do not reach the medullary cavity can be slowly regenerated endogenously, and the regenerated cartilage is hyaline cartilage.

(3) Cutting cartilage to bone and drilling: Cut away the full-thickness cartilage of the disease, expose the bone, and drill several holes with Kirschner wires to cause bleeding in the bone bed. The full-thickness defect of the articular cartilage deep into the medullary cavity can be repaired exogenously from the medullary cavity mesenchymal tissue. The above operations can be performed through arthroscopy, using a planer to cut, or through joint incision under direct vision.

2. Patellar plasty: After cutting away the diseased cartilage, if the exposed bone is large (2 to 3 cm), the adjacent synovium or a layer of fat pad can be cut and flipped over and sutured to cover the exposed bone surface.

3. Patellar resection: If the patient is older, has severe symptoms, has a large exposed bone area (more than 3 cm), and has relatively large wear of the femoral cartilage, and cannot undergo patellarplasty, patellar resection may be considered.