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Abstract: The patient, a 54-year-old male, came to the clinic with pain in both knees after walking up and down stairs or for a long time. After clear diagnosis, the patient was given glucosamine hydrochloride capsule and diacetin capsule, etc. After standard treatment, the patient’s knee pain was relieved and the knee function recovered well.
Basic information】Male, 54 years old
Disease Type】Osteophytes
Hospital】West China Hospital of Sichuan University, Tibetan Chengban Branch
Date of consultation】March 2022
Treatment plan】Oral medication (glucosamine hydrochloride capsule, diacetin capsule) + topical non-steroidal medication (flurbiprofen gel paste)
Treatment Period】Reviewed after 3 months of outpatient medication
Results】Knee pain was relieved and knee function recovered well.
I. Initial consultation
The patient is a Han Chinese who has been working in Tibet for a long time. 3 years ago, the patient developed anterolateral and anteromedial pain in both knees after going up and down stairs or walking for a long time, and the pain was relieved after resting, with no history of trauma to both knees and no morning stiffness in both knees. The present examination: the anteromedial side of both knees was slightly swollen and painful, and the function of both knees was good. The positive and lateral DR examination of both knees showed bilateral intercondylar ridge and patellofemoral joint edge became sharp, small patch-like hypointense shadow under the bony joint surface of the posterior edge of the right patella, the position relationship of both knees corresponded to each other, the joint space was narrow, and the left suprapatellar capsule was swollen. swelling of the left suprapatellar capsule.
II. Treatment
The patient was given oral glucosamine hydrochloride capsules and diacetin capsules, and topical flurbiprofen gel paste. The patient was advised to come to our hospital for injection of “sodium vitrate injection or PRP (platelet-rich plasma)” into the knee joint cavity to speed up recovery if the symptoms did not resolve significantly. The patient is advised to use knee pads to disperse the knee stress and keep the knee warm to promote recovery. Patients are advised to reduce stair climbing, hiking and strenuous exercise to avoid aggravation of symptoms. Reduce walking when the pain is severe, rest more, and use crutches or walkers to assist a small amount of walking if necessary to promote recovery. After the pain is relieved, you can participate in aerobic exercises, such as cycling and swimming, to control weight and enhance physical fitness, and strengthen the leg raising exercise to enhance the stability of the knee joint in general.
III. Treatment effect
After standardized medication and proper rest, the patient’s knee pain symptoms were relieved after 1 month. After 3 months of treatment, the patient reported that the knee pain was not obvious when walking up and down stairs, and there was no obvious swelling and pressure pain on the anterior medial side of the knee.
IV. Notes
We are glad that after active treatment the patient’s symptoms are significantly reduced. After discharge, the patient needs to quit smoking, limit alcohol, and usually reduce the intake of spicy and stimulating foods, such as chili, hotpot, and spicy hotpot. Pay attention to weight control, you can gradually resume exercise, gradually increase the amount of exercise, you can properly increase aerobic exercise, such as cycling, swimming, etc., you can also do leg lifting exercises to increase joint stability. Avoid prolonged standing and sitting, change your position frequently, and pay attention to the combination of work and rest. If joint pain and discomfort occur again, you need to follow up promptly.
V. Personal insight
Osteomalacia is a common and frequent disease, which may appear in everyone after middle age, but it can be prevented and treated. Exercise can enhance physical fitness and weight control, but too much, too big, too frequent exercise can lead to increased wear and tear on the joints, which can lead to osteophytes at a later stage, so exercise needs to be gradual and moderate. The surface of the knee has less skin and soft tissue and is more sensitive to cold stimulation, so you need to pay attention to keeping warm to avoid degeneration of joint cartilage. If you experience joint pain and discomfort, you should seek medical attention and, if necessary, use medication to treat the osteophytes and change your lifestyle and exercise routine to promote recovery. Late diagnosis or severe osteophytes require surgery.