I. Chronic injury of the upper end of the patellar ligament (used to be called patellar telangiectasia): manifested as pain at the lower pole of the patella, the lesion site is the intersection of the patella and the patellar tendon at the site of injury or strain, with obvious localized compression pain, and the quadriceps muscle is positively impeded. Reason: Inflammation caused by repeated contraction of the thigh quadriceps muscle due to a large number of jumping exercises, resulting in elongation of the knee ligaments. There are also cases of inflammation caused by the rapid growth period of the body, where the growth of muscles and tendons cannot catch up with the growth of bones. Symptoms: Pain in the patellar ligament, pain when extending the knee, pain before preparing for activities, pain when the knee joint is stretched by bending. Disposition: From a preventive point of view, it is important to strengthen flexibility exercises. Cold compresses can be applied when there is pain. Second, rheumatic diseases or autoimmune diseases (1) short duration of pain, usually 12-72 hours, but 3 weeks, mostly large joints, such as knees, elbows, shoulders and other joints (2) wandering pain, after the pain in one joint improves or has not yet improved significantly, another joint is attacked and pain occurs (3) pain at the same time, the skin may be accompanied by ring-shaped erythema or subcutaneous nodules. (4) Symmetric pain, the lesion may invade the same joints on both sides of the limbs at the same time, such as double knee, double elbow joints can occur at the same time (5) Pain can occur in more than one joint at the same time. (6) Joint pain is accompanied by redness, swelling, tenderness around the joint, and severe pain on pressure. (7) After the pain subsides, there is no joint ankylosis or deformity, and the joint function can be restored. Chondromalacia patellae is a chronic injury to the cartilage surface of the patella, cartilage swelling, erosion, cracking, crushing, detachment, and finally the femoral condyles relative to the same pathological changes, the formation of osteoarthropathy of the patellofemoral joints, knee fatigue or repeated sprains of the knee in a semi-squatting position, leading to the weakening of the knee joint around the muscular imbalance, resulting in the incoherence of friction, resulting in the abrasion of the cartilage surface, nutritional deficiencies, and the emergence of degenerative changes. Degenerative changes. At this time, the cartilage surface has no luster, the elasticity is weakened, and even the formation of cracks, defects, chondrogenic fibrosis, patellar articular surface cartilage has limited cartilage chondrogenic fibers formation, causing chronic pain in the knee joint. Because it is a degenerative lesion, there is a history of trauma or strain. Clinical manifestations: 1, gradually aggravated infrapatellar pain, knee pain, pain is aggravated when going up or down stairs or semi-squatting position. 2.Patellar edge pressure pain, knee extension position squeeze or push the patella can have friction feeling, with pain, later can be complicated by synovitis. 3, sometimes there may be “false interlocking” phenomenon, slight activity, in the patella under the crisp sound, can be “unlocked” (this is due to the chondral surface of the patella after the injury is not flat and the joint surface does not coincide with the cause). Sometimes the phenomenon of tenderness occurs. 4, X-ray early no abnormality, late see patellar edge of the bone cumbersome formation, 5, early by radionuclide bone imaging has diagnostic significance. Treatment: 1, first of all, knee braking 1-2 weeks, femoral 4 head muscle resistance exercise, in order to increase the stability of the knee joint. 2.Cold compresses when swelling and pain increase, and then moist heat compresses and physical therapy after 48 hours. 3.Orally take Fenpropidol capsule and Shujiweiqi tablets. 4.Intra-articular injection of sodium vitrate can lubricate and nourish the articular surface or intra-articular injection of Tretinoin injection. 5.If necessary, muscle relaxation. 5, if necessary, muscle release surgery. Fourth, infrapatellar fat pad inflammation: lesions in the infrapatellar fat pad tissue, due to injury or strain, cold and damp invasion and other stimuli, resulting in pain, but also by the joints of other tissues secondary to lesions. When checking, one hand will push the patella downward, and the other hand will squeeze the lower edge of the patella to produce pain. Fifth, meniscus injury: meniscus injury and chondromalacia patella have interlocking phenomenon, but the former is true, the latter is false, combined with other tests is not difficult to confirm the diagnosis. Sixth, osteoarthritis: also known as osteoarthrosis, mostly seen in elderly patients, clinical manifestations: joint extension and flexion to a certain extent when the pain caused by flexion and extension of unfavorable, squatting difficulties, etc. X-ray manifestation of osteoporosis, joint space narrowing, subchondral bone sclerosis, joint edge hyperplasia. Chondromalacia patella is mostly seen in middle and young people, joint pain in the patellofemoral joint surface and patella around, half squatting pain aggravation. Seven, treatment measures 1, release treatment: the pain and pressure points around the patella are the lesion sites of soft tissue injury. Commonly there are the following parts Pre-patellar subcutaneous bursa, located in the lower part of the patella, between the skin above the patellar ligament. Pain and tenderness in this area, that is, the prepatellar subcutaneous bursa, that is, the prepatellar subcutaneous bursa is damaged, and this bursa can be incised and peeled off with a small needle knife. The medial and lateral patellar support bands, the pain points are on both edges of the patella. It can be done by incision and release. The disease has up to twelve pain points around the patella, all of which can be made to disappear by small knife surgery. 2, manipulative treatment (1) the patient lying on his back, the affected limb straight, the doctor’s thumb and other four fingers open, grasp the patella, force up and down (along the longitudinal axis of the limb) sliding patella. This can make the joint capsule, supporting ligaments to further loosen. (2) The doctor holds the upper edge of the affected ankle joint with one hand, makes the patient bend the knee and hip, and the thumb of the other hand pushes against the upper edge of the patella, and then makes the affected limb straighten, and at the same time the thumb exerts force downward to push against the patella, and the direction of the downward force is straight downward and diagonally downward. (3) For those with knee extension and flexion disorders, use the over-extension and over-flexion sedation method and stay in the over-extension and over-flexion position for 30 seconds. 3.Rehabilitation ① 100 times of quadriceps contraction exercise every day, make straight leg raising exercise 100 times. ② doctor daily soft tissues around the patella to take one hand, each general take three times, not two days to do a passive hyperextension and hyperextension hand method. Ten times for a course of treatment, adhere to one to two courses of treatment can be cured.