Peng is a 52-year-old man who has been ardently in love with exercising since he was a child. Aside from boxing, he also enjoys running and mountaineering. Half a year ago his knees started swelling and changing shape, but painkillers and hyaluronic acid did not help. Eventually he also began experiencing unbearable pains in his lumbar region and back, so he decided to see an orthopedist, who diagnosed that the cartilage in his knees was severely damaged and had caused patellofemoral arthritis.
Liu Hwa-chang, a doctor in the orthopedic surgery department at Taiwan Adventist Hospital, says that 80 percent of people over the age of 65 in Taiwan have degenerative arthritis in their knees, and that with the decrease in temperatures during autumn and winter, the knees will make crackling sounds while moving, particularly when going up and down stairs, getting up or squatting on the toilet. Not only is the pain unbearable, but in some serious cases the knee also changes shape. Degenerative arthritis is not limited to seniors. Clinical studies show that many people in their 40s and 50s suffer from the condition from being obese, excessive exercise, moving heavy objects or wearing high heels too often. If the kneecaps endure heavy weight for an extended amount of time it causes damage to cartilage, which can lead to arthritis or patellofemoral pain syndrome (PFPS).
If overused, the patella, commonly known as the kneecap, can do harm to posterior cartilage and cause pain. Clinical studies show that people often go to the doctor due to pain in the kneecaps, but X-rays do not show anything. Orthopedists must first eliminate whether any abnormalities in the anterior or posterior joints exist and check to see if the joints of the kneecap are slanted or turning outward before determining if the patient has patellofemoral arthritis.
Photo: Tsai Tsung-hsun, Liberty Times
照片:自由時報記者蔡宗勳
Aside from using conservative therapy to treat patellofemoral arthritis, strengthening quadricep muscles and losing weight can also be used. If a doctor’s evaluation permits, the use of surgery might also be considered.
(Liberty Times, Translated by Kyle Jeffcoat)
五十二歲的彭先生從年輕時就酷愛運動,除了打拳擊外,也喜歡跑步及爬山,半年前雙腳膝蓋出現腫脹、變形,吃止痛藥及打玻尿酸都無效,最後腰背疼痛難耐,到骨科就醫,經診斷為膝蓋軟骨嚴重磨損,引起髕股骨關節炎。
Photo courtesy of Taiwan Adventist Hospital
照片由台安醫院提供
台安醫院骨科醫師劉華昌表示,台灣六十五歲以上老年人有八成罹患退化性膝關節炎,每到秋冬氣溫下降時,膝蓋活動時,就喀喀作響,尤其在上下樓梯、起身或蹲廁所時,不但疼痛難耐,嚴重者還會變形,但退化性關節炎不是老年人的專利。臨床上,常見許多四十到五十歲患者因肥胖、過度運動、搬重物或經常穿高跟鞋,膝蓋長期飽受過度承重造成軟骨磨損,引發關節炎或髕骨疼痛。
劉華昌指出,「髕骨」就是俗稱的「膝蓋骨」,長期過度使用會造成外側軟骨磨損,引起疼痛。臨床上,常見患者因膝蓋疼痛就醫,照了X光卻查不出問題。骨科醫師會先排除內、外側關節面異常問題,並檢查患者的髕股骨關節是否出現傾斜或外翻,以診斷患者是否罹患髕股骨關節炎。
髕股骨關節炎患者的治療除了採保守治療,藉由強化四頭肌力量強度及減重方式減緩外,若經醫師評估許可,可考慮手術治療。
(自由時報記者魏怡嘉)
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