2023-07-30 19:17:49
Definition: what is chondropathy of the knee?
The knee chondropathy is a pathology that affects the cartilage of the knee. The term comes from the Greek khondros meaning “cartilage” and pathos meaning “pain”. Chondropathy is often a prerequisite forknee osteoarthritis (or gonarthrosis) which corresponds to a more advanced stage of deterioration of the cartilage.
As a reminder, the cartilage is a flexible, sometimes elastic connective tissue that we find in the joints. It has a real protective role allowing optimal functioning of the joint. Indeed, it prevents the bones from rubbing against each other during movement. Thanks to it, the bones slide easily, which facilitates movement.
Chondropathy affects all surfaces of the joint and is observed by the cartilage deterioration who is visible on MRI. At first the chondropathy is asymptomatic. Mechanical pain (caused by movement) then sets in very gradually.
Note that if we are interested here in the chondropathy of the knee (which is the most common localization), this disease can actually affect all the other joints of the body: hip, shoulder, foot, ankle, spine…
What are the different types of chondropathy?
Three types of chondropathy of the knee should be distinguished.
Patellar chondropathy
Also called “patella syndrome“, it concerns a degeneration of the cartilage of the patella. It is often bilateral affecting both knees.
Patellofemoral chondropathy
It affects the patellofemoral joint, which connects the femur and the patella. It is common in young people (even adolescents) who complain of knee pain that rises when taking the stairs in particular. Growth is a risk factor.
Femorotibial chondropathy
This form of chrondropathy affects the localized joint between the femur and the tibia.
Chondropathy: what is the link with osteoarthritis?
As osteoarthritis, Chondropathy refers to cartilage degeneration. Nevertheless, chondropathy corresponds to the superficial and localized wear of the cartilage, while osteoarthritis is defined as the disappearance of the cartilage at the level of one or more joints (white area between the two bones). The risk factors for osteoarthritis are therefore the same as those for chondropathy. In addition, most of the time, chondropathy results in a knee osteoarthritis (gonarthrosis).
Causes: what causes chondropathy?
The chondropathie is the consequence of a overwork of the knee joint whose cartilage begins to deteriorate. The knee joint supports the whole weight of the body and it is very stressed on a daily basis, especially among athletes or people who provide significant or even excessive physical effort (whether in the context of their lifestyle or their work). . We therefore understand why the suffering of the cartilages in this place is a widespread phenomenon.
Certain factors increase the risk of triggering chondropathy:
- The aging (since the tissues of the body, of which the cartilage is a part, deteriorate with age);
- The overweight even obesity (since the overload that the body has to bear rests on the knees);
- THE excessive physical exertion ;
- Of the misguided movements during physical activity ;
- And joint trauma ;
- A knee instability (ligament laxity);
- A knee axis deviation like a knee joint(bow legs) or one genu valgum (knees in X).
- In women, the decrease in estrogen hormoneswhich would accelerate the degradation of cartilage.
Symptoms: how does chondropathy manifest?
At the onset of the disease, the patient usually does not have pain. It is only afterwards that a mechanical pain (when moving) often pushes him to consult. The pain is also worse when posture changes (such as going from squatting to standing, for example). Resting generally reduces the pain, but the patient may still feel discomfort.
How does a chondropathy evolve?
L’evolution of chondropathy is very slow and highly variable depending on the individual, the shape of their lower limbs (X-shaped or arched), the sports practiced, their weight, any injuries… It is usually very slow. It should be noted that the disease can appear very early in life (sometimes as early as adolescence), without the patient being condemned to experience complications in adulthood.
Possible complications
Untreated chondropathy leads to a vicious circle of cartilage destruction:
- First, the lubricant present becomes ineffective and the body to compensate for this, will produce much more of this liquid which will cause the joint to swell, called “synovial effusion” (or hydrarthrose) in the joint.
- Left untreated, this excess non-performing joint fluid cannot exit the knee. A popliteal cyst (or Baker’s cyst) then develops on the back of the knee, causing discomfort.
- Finally, in the absence of care, the chondropathy develops until the complete disappearance of the cartilage at the ends of the bones. We then speak of osteoarthritis, which is the advanced stage of chondropathy. It leads to particularly painful mobility and the formation of parrot beaks (called osteophytes)
The risk of this cascade is a significant loss of mobility for patients, compromising their quality of life and their autonomy.
Diagnosis: how do you know if you have chondropathy?
L’physical examination and a complete history allow the doctor to know the patient’s health history and assess the patient’s symptoms. The first consultation makes it possible to ask diagnostic. L’medical imaging (x-ray, scanner, IRM) is needed to assess cartilage thickness and diagnose the stage of chondropathy.
Prevention: how to avoid chondropathy?
To prevent chondropathy and its complications, it is essential to fight against the main risk factors such as overweight, joint trauma, repetitive strain injuries and certain anomalies of the statics of the lower limbs.
- If you are overweight or obese, it is recommended to losing weight.
- It is advisable to engage in regular physical activity, possibly including the practice of a sport. It is best to alternate sports with and without impacts. The ideal is to practice swimming, walking, muscle building (bodyweight) or the cycling. The running should not be practiced every day. Any sport that would aggravate your joint pain should be avoided.
- If you have a joint abnormality, you may be offered surgery.
Treatments: how to treat knee chondropathy?
If chondropathy is diagnosed, appropriate treatment should be instituted by a specialist at the first signs of pain or discomfort.
It is possible to reduce the inflammatory reaction by administering anti-inflammatories. This is’nonsteroidal anti-inflammatory drugs and D’steroidal anti-inflammatories or cortisone by infiltration (injection performed directly into the joint).
The cold is also a natural anti-inflammatory, so you can apply an ice pack to your knee in case of pain.
Typically, support also includes chondroprotectors (hyaluronic acid, glucosamine and chondroitin). These drugs have the ability to nourish the cartilage and contribute to better lubrication. There glucosamine and the chondroitin are administered orally. I’hyaluronic acid is given by injection into the joint.
It is also possible to make PRP injectionsplatelet-rich plasma, which is taken from the patient during a blood test and injected into the area to be treated. If this treatment is effective, it remains expensive and not covered by social security.
The functional rehabilitation with a physiotherapist (including muscle-strengthening exercises) is central to the management of chondropathy. It aims to adapt your articular and muscular system to your different daily functional needs.
Of the Orthopedic sole are sometimes necessary to better align the lower limb, better distribute the loads and reduce the stresses on the joint in pain.
Wear a knee pad can also prove to be a major asset in relieving your pain.
A vitamin C, D and E supplementation is recommended as part of a healthy and balanced diet.
A weightloss is highly recommended for people who are overweight or obese.
In the event of failure of the conservative treatments above, or of very advanced wear, recourse to a surgical treatment may be offered to relieve pain and improve function. Several surgical options can be considered depending on the lesions diagnosed.
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