Patellofemoral joint pain

　　Patellofemoral joint pain syndrome is the most common knee problem in active adults and adolescents. The pain is often located in the anterior and medial, anterior and lateral, or posterior parts of the patella. It usually occurs during downhill movement and even if not running, there will be pain (especially when descending stairs). The patellofemoral joint is composed of the patella and the trochlear articular surface of the femur, and its stable structure includes the longitudinal quadriceps tendon, patellar ligament, and lateral femoral oblique muscles, medial and lateral support bands, and iliotibial band; the patella and the trochlear articular surface of the femur begin to contact at 20 degrees of knee flexion, and as the angle of knee flexion increases, the contact area between the patella and the trochlear articular surface of the femur also increases, and the pressure between the patellofemoral joints reaches its highest at 60-90 degrees of knee flexion. When the knee is flexed beyond 90 degrees, the quadriceps tendon contacts the femur, reducing the pressure on the patellofemoral joint.

　　The causes of patellofemoral joint pain include: congenital high patella, patellar cartilage fibrosis (when the patient sits with the knee flexed to 90°, if the patella is facing upward, it usually indicates congenital high patella), tightness of the hamstrings, Achilles tendinitis, vastus lateralis, patellar retinaculum, and lateral support ligament tightness, atrophy of the vastus medialis, and Q angle (the angle between the patellar ligament and the longitudinal axis of the thigh) greater than 15°. When the lower leg is internally rotated, the vastus medialis pulls the patella inward, while the other three muscles pull it outward. The most common cause is excessive internal rotation, which pulls the patella outward and collides with the lateral condyle of the femur. The pain caused by the patellofemoral joint is generally believed to be due to excessive overload on the patellar surface and excessive tension in the lateral ligament.

　　Pain below the patella is the most common cause of the disease. The disease originates from patellofemoral joint impingement or prolonged friction on the bone surface, often leading to softening of the patellar cartilage, patellar pain syndrome, or 'runner's knee', usually occurring in women and inappropriately trained 'deep squat' practitioners.

　　The most common cause of patellofemoral joint pain is excessive internal rotation, which pulls the patella outward and collides with the lateral condyle of the femur. It is usually accompanied by congenital high patella and other symptoms, and generally has no other serious complications. It can cause local swelling and pain, especially when descending hills, leading to dyskinesia in patients.

　　Pain is often located in the anterior medial, anterior lateral, or posterior part of the patella. It usually occurs during downhill movement, and even if you do not run, there may be pain (especially when going down stairs). The patellofemoral joint is composed of the patella and the femoral trochlea articular surface, and its stable structure includes the longitudinal quadriceps tendon, patellar ligament, and lateral vastus medialis and lateralis, as well as the medial and lateral support bands and iliotibial band; the patella and the femoral trochlea articular surface begin to contact at 20 degrees of knee flexion, and as the angle of knee flexion increases, the contact area between the patella and the femoral trochlea articular surface also increases, and the pressure between the patellofemoral joint reaches its highest at 60-90 degrees of knee flexion. When the knee is flexed beyond 90 degrees, the quadriceps tendon contacts the femur, reducing the pressure on the patellofemoral joint.

　　Clinical manifestations:

　　① Pain occurs inside the knee joint, around the patella, or below the patella.

　　② Pain occurs below the patella when bending or extending the knee.

　　③ Pain is felt along the medial edge of the patella.

　　④ Swelling may be present.

　　⑤ Climbing hills or stairs can exacerbate the disease.

　　Patellofemoral joint pain is the most common knee problem in active adults and adolescents. The causes of patellofemoral joint pain include: congenital high patella, patellar cartilage fibrosis, tightness of the hamstrings, Achilles tendinitis, vastus lateralis, patellar retinaculum, and lateral support ligament tightness, atrophy of the vastus medialis, and Q angle (the angle between the patellar ligament and the longitudinal axis of the thigh) greater than 15°. So how should patellofemoral joint pain be prevented? Daily precautions for preventing patellofemoral joint pain should include the following points:

　　1. Avoid knee injuries

　　2. Avoid abnormal stress on the knee joint

　　3. Pay attention to the warmth of the knee joint, avoid catching a cold

　　4. Pay attention to exercise and strengthen the strength of the quadriceps muscle in daily life

　　5. If there is an abnormal force line of the extensor mechanism, it should be corrected surgically in a timely manner.

　　Patellofemoral joint pain usually occurs in the anterior and medial, anterior and lateral, or posterior part of the patella. It usually appears during downhill exercise and may cause pain even without running (especially when descending stairs).

　　Possible causes of patellofemoral joint pain include congenital high patella syndrome, patellar cartilage fibrosis, tightness of the hamstrings, Achilles tendinitis, quadriceps femoris, patellar band and lateral retinaculum tightness, atrophy of the vastus medialis muscle, and Q-angle (the angle between the patellar ligament and the longitudinal axis of the thigh) >15°. When the lower leg is internally rotated, the vastus medialis muscle pulls the patella inward, while the other three muscles pull it outward. The most common cause is the outward pull of the patella after excessive internal rotation, which collides with the lateral condyle of the femur. Then, what are the examination items for patellofemoral joint pain?

　　1. CT examination of bones, joints, and soft tissues

　　CT examination of bones, joints, and soft tissues is a method of examining bones, joints, and soft tissues through CT.

　　2. Radiography of the bones and joints of the limbs

　　The radiography of the bones and joints of the limbs is to take X-rays of the limbs and related joints, used to confirm the bone condition after a fracture.

　　3. Joint examination

　　Joint examination is a comprehensive examination of all bones and joints in the body, used for diagnosing various joint diseases.

　　Patellofemoral joint pain is a common clinical disease and one of the main causes of knee pain. Its pathogenesis is related to the imbalance of muscle strength around the patella, leading to an abnormal running track of the patella during flexion and extension of the knee joint. The increase of patellofemoral joint stress, fatigue, and trauma, the reduction of the elasticity of the quadriceps muscle, the limitation of the range of motion of the patella, and the contraction of the lateral patellar retinaculum are all important causes. Most patients complain of pain at the posterior or peripheral area of the patella, which is significant during knee flexion and running. Physical examination shows limited or excessive movement of the patella, as well as pathological signs around the patella. Imaging examinations are of great significance for diagnosis and treatment. Treatment can be carried out by taking oral non-steroidal anti-inflammatory analgesics, physical therapy, and braces, etc., conservative methods. For patients whose conservative treatment is ineffective, surgical treatment can be considered.

　　While receiving timely and reasonable treatment, patients with patellofemoral joint pain should also pay attention to the nourishment of their diet. Reasonable dietary care is conducive to the early repair of the injury.

　　Firstly, it is necessary to increase protein intake. Protein is highly beneficial for the recovery of body tissues. It is recommended to consume an additional 10 grams of protein daily, which can be provided by 200 milliliters of low-fat yogurt, 300 milliliters of skim milk, 30 grams of lean meat, poultry meat, or fish, 60 grams of beans, or 40 grams of low-fat cheese.

　　Secondly, during the recovery period from the injury, it is also important to supplement vitamin C and zinc. Vitamin C and zinc also help the body to repair itself. Citrus fruits, cauliflower, green peppers, tomatoes, potatoes, and strawberries are rich in vitamin C. Foods rich in zinc include oysters, crabs, black chicken, yogurt, milk, almonds, peanuts, cashews, and chickpeas.

　　Moreover, during the recovery period from the injury, one can also try turmeric powder and mustard. More and more scientific evidence shows that turmeric has the same analgesic effect as drugs like Celebrex and Vioxx, with no side effects. Therefore, nutrition experts recommend sprinkling a little turmeric powder on salads, soups, vegetables, or meat and poultry. Eating mustard is also fine, as mustard also contains a small amount of turmeric powder.

　　In addition, during the recovery period of the injury, one can consider eating whole wheat bread, pasta, and rice, and pair them with a large amount of vegetables. Experts say that these foods are rich in rough fiber, can produce a feeling of fullness, but have low calories. Therefore, they can keep people's mouths busy without the worry of gaining weight.

　　Patellofemoral joint pain is the most common knee problem in active adults and adolescents. Causes of patellofemoral joint pain can include: congenital high patella syndrome, patellar cartilage fibrosis, tightness of the hamstrings, Achilles tendinitis, tension of the vastus lateralis, patellar muscle bundle, and lateral supporting ligaments, atrophy of the vastus medialis, and Q angle (angle between the patellar ligament and the longitudinal axis of the thigh) >15°. When the lower leg is internally rotated, the vastus medialis pulls the patella inward, while the other three muscles pull outward. The most common cause is that after excessive internal rotation, the patella is pulled outward and impacts the lateral condyle of the femur.

　　The main treatment for this disease is physical therapy, in addition to heat therapy and electrotherapy, it also requires exercise therapy. It is usually possible to achieve therapeutic effects by training the muscle groups of the knee area, but in recent years, it has been found that the muscle groups around the hip joint also need to be trained. Generally, it takes only 2 weeks to see initial effects, and a complete course of treatment requires 6 to 8 weeks, training 3 times a week, 30 to 40 minutes each time.