June 10, 2011
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Disease Koenig Or osteochondrosis dissecans of the hip and knee joints - A type of osteochondropathy, the disease is characterized by necrosis of the subchondral portion of the articular surface of the bone with its further separation from the cartilage. In the process of separating osteochondral fragment falls into the joint cavity, forming a so-called "articular mouse", its size can range from a millet seed to the size of the beans.
The first is a disease of the knee joint was described by the German surgeon Franz Koenig , He assumed the cause of the pathology is trauma. After conducting a number of studies it has been hypothesized that claims about genetic predisposition to the disease. The exact causes of dissecting osteochondrosis is not yet known, but presumably the disease is due to hereditary characteristics in the structure of the joints, endocrine disorders, repeated small injuries, deep vein thrombosis . These factors lead to impaired blood supply to the bone in the joint, cartilage and under noninfectious hearth necrosis occurs. Necrosis area osteochondral tissue leads to the formation of clots in blood vessels, which further worsens the blood supply and greatly contributes to the rejection of the bone.
Osteochondrosis dissecans often affects the area knee joint . Less likely to suffer a hip, ray, ankle, and elbow joints. Developing the disease between the ages of 15 to 35 years, but can also occur in children and the elderly. More common in men than women, due to a more active lifestyle and traumatic.
Diagnosis and symptoms Koenig
Disease proceeds is long enough without obvious clinical manifestations. In many cases, the development of the disease due to injuries the symptoms are perceived as traumatic injuries. In rare cases, it may be an acute onset of the disease immediately after the injury, most symptoms increase gradually after a while after the injury.
From the increase in disease symptoms Koenig has four stages. Diagnosed with the help of X-ray studies. If necessary to clarify the stage of the disease is carried out computer and magnetic resonance tomography, ultrasound. In severe cases, arthroscopy is used, in which using the arthroscope through small incisions explores the inner surface of the joint.
The first stage of the disease manifested mild clinical symptoms. The most common symptoms are as Koenig discomfort and mild pain in the joint with a load on it. In the diagnosis on radiographs observed necrosis wedge or oval.
In the second stage with a load on the joint pain is stronger, there is swelling. The pains are worse when bending the knee, walking at a palpation. On radiographs clearly visible site necrosis.
In the third stage starts to happen rejection of necrotic area. Osteochondral fragment is not yet fully separated leading to joint contractures. If the diagnosis can not see the shadow of the breakaway region.
Osteochondrosis dissecans fourth stage is characterized by increased pain and inflammation. In this phase of the disease nekrotizirovany plot completely rejected the joint cavity. Migration articular mice leads to increased symptoms. In the diagnosis of intra-articular body clearly visible. Often there musculo-articular dysfunction , Joint stops moving and the muscles gradually atrophy.
Treatment of the disease Koenig
In the early stages of the disease applied Conservative treatment of diseases Koenig . Prescriber improving blood supply joints metabolism in bone regenerating bone tissue, and others. Completely relieve the load on the damaged joint, this is assigned to walking on crutches for two months, and then if there are no such symptoms Koenig pain and swelling applied massage, medical gymnastics, electromagnetic stimulation. Conservative treatment lasts about 1-1, 5 years.
In the later stages, or under heavy loads, such as athletes, conduct Surgical treatment of diseases Koenig . During the operation, removed nekrotizirovany portion and separated fragment were stimulated recovery of cartilage covering the joint.
Operations using the arthroscopic technique less traumatic. After removal of the joint mouse joint cavity is filled with a special compound that promotes tissue regeneration.
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