Kneecap Calcification

Introduction

In patellofemoral calcification, the kneecap is affected. It causes anterior knee pain and climbing stairs becomes painful. The kneecap is called Patella in medical language.

Anatomy

The patella (kneecap) is a small flat bone and is located on a groove in the front of the knee. The patella is attached to the thigh and shin bone through beams called tendons. When we are in a sitting position, it allows us to lift our calves straight through our knees. During this movement, the patella moves up and down in the femoral groove of the thigh bone.

In order for the movement between the kneecap and the groove to be easy, the surfaces of both are covered with cartilage.

Definition

Definition

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The cartilage in the patellofemoral joint wears out over time and the cartilage peels off, causing the joint to deform, which is called patellofemoral arthrosis or kneecap calcification. When the cartilage disappears, the bone is exposed, friction is impaired and movement becomes painful.

•  Patella Fractures; Post-fracture joint irregularities or cartilage damage may cause calcification by creating cascading on friction surfaces.
• Dysplasia; Incomplete fit of the patella into the femoral groove or mutual incompatibility may lead to excessive friction and unbalanced pressure in the joint, leading to wear and calcification.

Clinical Findings

The main complaint in patellofemoral arthrosis. It is pain. Every time you move your knee, there will be pain and tenderness radiating to the front of the knee. Particularly, your pain:

• Using stairs,
• Squatting,
• Sitting and standing up for prayer,
• Using a Turkish toilet,
• And in later cases, it will increase when getting up from a chair and walking straight.

If the disease progresses too much, you may hear rubbing and tripping sounds from your knee, which people next to you will hear.

Treatment

Non-Surgical Treatment

It is generally treated like knee arthritis. The aim of the treatment is to reduce pain and reduce knee functions. Patient satisfaction is the main principle.
In the early stages of calcification, non-surgical methods are used;
Exercise, supportive devices, lifestyle changes and others. Non-surgical treatment methods consist of four main headings: Changing lifestyle; It is necessary to restrict activities that aggravate the situation, such as climbing stairs, cycling or bending the knee. Most, if not all, patients are overweight and should be helped to lose weight. The load and stress on the knee should be reduced by losing weight. Weight loss should first start with a diet program.
Exercise; It is aimed to increase the ligament and muscle strength around the knee. Squatting and using stairs are reduced. Supportive devices; Knee braces can provide temporary relief.
Other Methods; Hot-cold applications, elastic bandages, and intra-knee cartilage injections can provide temporary relief.

Drug Treatments

There are many types of drug treatments, but not every patient gets the same response. Your doctor will make a choice based on your situation.

• Anti-inflammatory drugs; These types of painkillers are usually the first choice. It is expected to reduce swelling and pain. However, using these drugs throughout life may cause some side effects.
• Glucosamines and Chondrotin Sulfates; Such oral supplement tablets can reduce pain. They may be useful in cases of early onset calcification. These drugs are considered food supplements and can be used in some diseases with the recommendation of a physician. These substances increase mobility and reduce pain. To get an effect from these additives, it is necessary to use them continuously for at least 2-3 months.
• Corticosteroids; They are powerful anti-inflammatory drugs and are injected into the knee. These are given for moderate to severe pain. They can be very helpful if there is swelling. These drugs should be administered in limited numbers. It also carries some risks; Increase in infection and cartilage damage
• Viscosupplementation-Intra-Knee Cartilage Needles-; Artificial cartilage fluids can be injected into the knee, increasing the lubrication in the knee joint, reducing friction and wear, resulting in a decrease in pain and increased movements.

Surgical Treatment

If treatment with non-surgical methods is unsuccessful. Surgery may be recommended. There are various types of surgery.

• • Chondroplasty; Arthroscopically, the joint surfaces are cleaned and smoothed.
  • Correcting the Kneecap Alignment; blisters on both sides of the patella By intervening with the meshes, the patella is placed in the groove.
  • Cartilage grafts; In young people and those with small cartilage defects, cartilage transplantation may be considered.
  • Tibial Tuberositas Transfer; The aim here is to reduce the friction and wear in the groove by relocating the kneecap. By reducing the pressure on the patels, smoother movement in the groove can be achieved.

• Patellofemoral Joint Prosthesis; Here is a separate treatment plan for patients who do not benefit from the above treatments or who we do not think will benefit. Cartilages are removed and a joint prosthesis, which we call partial, is applied to the patella-femoral groove. The prosthesis consists of metal and polyethylene plastic. If there is calcification in other joint components of the knee, total knee replacement surgery is performed.

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