Knie-artrose

Fietsen verstandig?

Feit

Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling

Meniscus-scheur

Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD

Kruisbandoperaties

Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction

Fact

Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?

Fact

When running, the knee is loaded with 6x your body weight with each step

Arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in a young study population: a randomised controlled trial

Abstract OBJECTIVE: To compare outcomes from...

Sabine J A van der Graaff, Susanne M Eijgenraam, Duncan E Meuffels, Eline M van Es, Jan A N Verhaar, Dirk Jan Hofstee, Kiem Gie Auw Yang, Julia C A Noorduyn, Ewoud R A van Arkel, Igor C J B van den Brand, Rob P A Janssen, Wai-Yan Liu, Sita M A Bierma-Zeinstra, Max Reijman
British Journal of Sports Medicine. E-pub ahead of print - 8 Jun 2022. http://doi.org/10.1136/bjsports-2021-105059
read more

A tailored intervention does not reduce low value MRI’s and arthroscopies in degenerative knee disease when the secular time trend is taken into account: a difference-in-difference analysis

Abstract Purpose: To evaluate the effectiveness...

T. Rietbergen, P.J. Marang-van de Mheen, J. de Graaf, R.L. Diercks, R.P.A. Janssen, H.M.J. van der Linden-van der Zwaag, M.E. van den Akker-van Marle, E.W. Steyerberg, R.G.H.H. Nelissen, L. van Bodegom-Vos (Corresponding author), P. Pander, D.J. Hofstee, R.C.I. van Geenen, K.L.M. Koenraadt, J. P.A.H. Onderwater, Y. V. Kleinlugtenbelt, T. Gosens, T.V.S. Klos, P. C. Rijk, B. DijkstraShow lessA.V.C.M. Zeegers, R.A.G. Hoogeslag, M.H.A. Huis in't Veld, A.A. Polak, N.R. Paulino Pereira, T.M.J.S. Vervest, H.C. van der Veen, N. Lopuhaä
Knee Surgery, Sports Traumatology, Arthroscopy, E-pub ahead of print - 7 Apr 2022. https://doi.org/10.1007/s00167-022-06949-w
read more

Anterior knee pain

What is anterior knee pain?

Anterior knee pain is defined by symptoms of discomfort in and around the kneecap (patella). It may occur at any age but seems most dominant in adolescents. Anterior knee pain occurs more often in women than men. It is also known as patellofemoral pain.

Knieschijf loopt door groeve van bovenbeen

The knee joint is the articulation between the upperleg (femur) and lower leg (tibia). The patella is the bone in front of the knee, The muscles in the front of the upperleg are called quadriceps muscles. They attach to the patella which in turn connects to the lower leg by the patellar tendon. The patella runs through a bony groove of the femur (trochlea) covered by cartilage when the knee flexes and extends. The patella also has a cartilage cover. The patella works as a lever due to the great forces placed on the muscles in knee flexion and extension.

Symptoms

Anterior knee pain occurs most frequently in deep flexion moments of the knee such as stair climbing, squatting and sittiing with bent knees for longer period of time. patellofemorale pijn tussen knieschijf en bovenbeen

Causes

The causes are not fully understood. Slight maltracking of the patella through the trochlea frequently occurs with quadriceps disbalance, after knee injuries. Other causes are overweight, osteoarthritis, leg malalignement, trauma to the knee, posterior cruciate ligament injury or sports overuse. In adolescents, this is often related to periods of physical growth. This maltracking leads to pain of the patella and surrounding tissues. Patella partita (loose bone parts) of the patella is a rare cause for anterior knee pain. An X-ray can detect this patella anomaly. Sometimes, the specific cause for the anterior knee pain is not found.

Treatment

The following treatment can reduce the symptoms of anterior knee pain: 1) relative periods of rest and analgesic medication and/or 2) exercises. Often both treatments are combined. It is important to understand that the pain may be annoying but innocent. There is no damage to the knee in the long run. You are allowed to move your knee even if complaints occur.

1. Relative rest periods and analgesic medication

The activities that provoke the complaints (stairclimbing, squat, kneeling) should be prevented as much as possible. Icing of the knee, non steroidal anti-inflammatory drugs (NSAID) and paracetamol may significantly reduce symptoms.

2. Exercises to improve quadriceps balance

The quadriceps muscles, especially the innerside upper leg muscle, is essential for adequate patella tracking through the trochlea. It is important to train this specific muscle (Vastus medial muscle). The following muscle strengthening exercise should be performed for at least 4 months to achieve adequate results. Place a small pillow below your knee and extend the leg. Keep the leg in the air for 10 seconds and then let it rest for 5 seconds. This is one cycle of exercise. You can feel the inner quadriceps tighten, without loading the painful patella. Repeat the exercises twice a day, in 3 series of 15 cycles. Be careful! Fitness machine exercises such as leg press, leg raise and rowing machines are unwise. The anterior knee pain will often increase and may persist.

Treatment in case of less pain symptoms

If the pain is less severe, you may start the next exercises. No weights or fitness machines, this overloads the patella.

1. Muscle strengthening exercises – squat

You may also perform this exercise on a slight ramp. Repeat the exercises twice a day, in 3 series of 15. If squatting on two legs goes well,  you may proceed with the more strenuous exercise (squat on one leg).

  • Squatting on both legs

    Stand up straight with your feet next to each other. Bend through your knees while working your quadriceps actively.

  • Squatting on one leg

    Stand on one leg, bend through your knee and tension your quadriceps actively.

2. Muscle stretching

In addition to the muscle strengthening exercises, it is also important to maintain adequate muscle length. If the muscles are too short, there is excessive pull on the patella with pain. The following stretching exercises are recommended 3 times daily. Keep up the stretching for 20-30 seconds and repeat the exercise 3 times.

  • Quadriceps stretching

    Stand on on leg en place the heel of the other foot to your buttocks. You will sense tension on the front muscles of your upper leg.

  • Hamstring stretching

    Sit on a flat surface en bring your hands toward your ankles. You will feel tension on the muscles in the back of your upper leg.

  • Stretching of calf muscles

    Make one step forward with one leg. The other leg should be straightened with the heel remaining on the floor. You will feel tension in the calf muscles.