What is this swelling on the front of my knee?

This is the 3124th article of Da Yi Xiao Hu

A few days ago, I met a young student in the clinic. He loves sports very much and exercises for more than two or three hours almost every day. In the past week, he had obvious swelling and pain in the front of his knee and could not walk normally, which seriously affected his daily life, so he came to the clinic for treatment.

The parents thought it was normal growing pains, but after careful questioning, they found out that the child was 14 years old, 1.68 meters tall, and had not grown rapidly for several years. Moreover, the pain was in front of the knee, with obvious swelling and tenderness, not in the thigh or calf where the bone grew. So they did an X-ray to find the cause as usual.

The result is typical tibial tubercle osteochondritis, so there will be obvious swelling and pain in the front of the knee and limited movement. Then readers can't help but ask, what is this disease and how to treat it? Let me give you some popular science.

Osteochondritis of the patellar tubercle is one of the common diseases in the growth and development period of adolescents. It is because the epiphysis of the tibial tubercle has not yet been completely calcified during adolescence, and it is the insertion point of the patellar ligament, which is easily stretched. During sports training, the quadriceps muscle is repeatedly and strongly contracted, and the patellar ligament and epiphysis are strongly stretched or long-term strained, causing bleeding, edema and hematoma organization at the insertion point of the patellar ligament, thus forming aseptic inflammation at the epiphysis of the tibial tubercle, and the calcification and ossification of the adjacent lesions cause local protrusions.

The main symptoms are localized swelling and pain at the tibial tubercle in front of the knee (the position indicated by the arrow in the above picture). The pain is obvious when going up and down stairs, running and jumping. When kneeling, the local patellar ligament is stretched and stretched, and the pain is aggravated by direct compression. The pain can be relieved or disappear after rest.

So how should it be treated? Since the cause is improper and excessive exercise or not properly treated after injury, the treatment can be simply summarized as follows:

1. Strictly limit the movement of the knee joint to reduce the traction and stimulation of the ligaments.

2. The joint can be fixed in the extended position with plaster or brace for 4-6 weeks.

3. Nonsteroidal anti-inflammatory drugs can be taken orally or applied topically to relieve symptoms.

4. Reduce physical exercise before the epiphysis closes to reduce stimulation to this area.

The above is some popular science knowledge about tibial tubercle osteochondritis. I hope that after reading it, you will be inspired and understand the treatment and prevention of this disease.

Author: Ju Yufeng, Department of Orthopedics, Shanghai Seventh People's Hospital