Sinding-Larsen's disease

Synonyms

• Sinding-Larsen's disease
• Patellar tip syndrome
• Sinding-Larsen-Johansson disease
• Larsen Johansson Disease

introduction

In the case of the term Sinding-Larsen's disease known disease is an extremely painful inflammatory reaction in the area of Knee joint.

The inflammatory processes typical of Sinding-Larsen's disease have their origin in the Kneecap tendon (Patellar tendon, Tendon of Quadriceps muscle) and manifest themselves primarily in the Tip of the kneecap. As the inflammatory processes spread, it can lead to Detachment of one or more pieces of bone come. The direct consequence is often this Development of pronounced bone necrosis. For this reason, the actually inflammatory disease Sinding-Larsen's disease belongs to the group of osteonecrosis (diseases in which bone parts die off).
The majority of affected patients are young people. Sinding-Larsen's disease occurs increasingly among athletes on. A direct comparison between women and men shows that there are significantly more male patients among those affected.

causes

The cause of Sinding-Larsen's disease appears to be one chronic overuse of the kneecap to be justified. More precisely it comes through a long-term stress on the affected knee joint to an increase in the stress on the tendons and the bone transition in the area of ​​the kneecap tip.

Sinding-Larsen's disease occurs more frequently in people who have their kneecap tendons in particular violent, unfamiliar and repeated tensile stresses expose. Furthermore, a distinction is made between the causes of Sinding-Larsen's disease internal and external influencing factors.
The main cause of this bone disease seems to be a common one Maximum stress on the tendon of the great anterior thigh muscle (Quadriceps muscle) to be. Just at Jumping sports According to experts, such a maximum load is particularly common. Because of this, it exists mainly for Basketball and volleyball players an increased risk of developing Sinding-Larsen's disease. In addition, the Long and / or high jump observe a particularly large number of Sindling-Larson cases.

However, it is not just the maximum strain on the kneecap tendon that plays a role in the development of the disease. Especially the lack of habituation Such strain on the tendon seems to play a decisive role. Because of this, especially Beginners of risky sports particularly at risk of developing Sinding-Larsen's disease.

For the sports mentioned above, there is a particularly high risk of developing kneecap necrosis, but more cases of Sinding-Larsen's disease can also be observed in patients who do less strenuous activities. There is therefore a clear risk for Tennis player, Weightlifter, Cyclists and jogger. In addition to these external influencing factors, so-called “internal risk factors” for the development of patellar necrosis have now also been identified. So people are with congenital or acquired elevated kneecap (Technical term: patella alta) particularly endangered. Furthermore, a reduced elasticity of the muscles adjacent to the knee joint is said to favor the development of the disease. Also one hereditary (genetic) component could not be excluded so far in the development of Sinding-Larsen's disease.

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The knee joint is one of the joints with the greatest stress.

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Symptoms

The symptoms of the Sinding-Larsen's disease are fairly general and can take a number of Diseases of the knee joint be assigned. For this reason, in the event of persistent complaints in the knee area, a specialist should urgently be consulted and a diagnosis should be sought.

Patients with Sinding-Larsen's disease usually report of severe pain in the affected knee. In many cases, the exact localization of this pain can be assigned to the tip of the kneecap in the early stages. Especially after a physical stress situation, this pain is described as particularly pronounced and stressful. Depending on the extent and stage of the disease, the typical symptoms of Sinding-Larsen's disease disappear after a short warm-up phase and only recur after the end of the sporting activity. However, patients who suffer from advanced Sinding-Larsen's disease usually feel it both during rest and exercise phases clear pain in the area of ​​the kneecap tip. In addition, it can intermittently Redness and / or swelling come on the affected knee.

Classically, Sinding-Larsen's disease is clinically in four degrees assigned:

1. Grade: pain kicks only after the end of the load on
2. Degree: At the beginning of the load significant pain occurs. These disappear during exercise and reappear after stopping.
3. Degree: Pain persists (at rest and during exercise)
4. Degree: It comes to one Torn kneecap tendon

diagnosis

The diagnosis of the Sinding-Larsen's disease is divided into different steps:

• At the beginning there is usually one extensive doctor-patient discussion (anamnese) takes place, in which the attending physician addresses the symptoms. In addition, lifestyle habits (sport, etc.) and possible previous illnesses of the patient also play a decisive role.
• The attending physician will then provide a physical examination carry out. This exam will not just look at the sore knee but rather also all adjacent joints and assess the healthy side of the body. For patients suffering from Sinding-Larsen's disease, this physical examination usually comes to mind severe pressure pain above the lower tip of the kneecap. In addition, in patients with Sinding-Larsen's disease, the affected knee can only be fully extended with pain.
• If the suspicion of Sinding-Larsen's disease is confirmed after the first diagnostic steps, a Ultrasound examination of the knee. In severe and / or pronounced cases, ultrasound can already be performed Changes in bone structure depict. For a reliable diagnosis, however, a Magnetic resonance examination (MRI) performed. Only with the help of an MRI can the extent of the disease be reliably assessed and possible therapeutic steps weighed up.

therapy

The treatment of Sinding-Larsen's disease is divided into non-operative (conservative) and operative measures. Depending on the extent and stage of the disease, another type of treatment is particularly suitable for promoting the regeneration of the affected knee.

In the beginning, however, this applies to all those affected to spare the corresponding knees and to avoid further overloading. For this purpose, in most cases a temporary sports leave pronounced. The most frequently performed conservative forms of therapy in patients suffering from Sinding-Larsen's disease are the use of warm and / or cold compresses and the so-called Electrical stimulation (Synonyms: iontophoresis, TENS). In many cases, the targeted application of ultrasound enormous treatment successes can be achieved. In addition to reducing the load on the affected knee should be done at regular intervals physiotherapy exercises and manual therapies be performed.
Furthermore, the so-called Shock wave treatment as a suitable method in the therapy of patients suffering from Sinding-Larsen's disease. In general, all of the methods described combine one common therapy goal: the Regeneration of the tendon attachment should be stimulated by local metabolic activation and an increase in regional blood flow. In addition, the tensile forces acting on the kneecap should be controlled by a Loosening of the thigh muscles be reduced. This still applies regular application of anti-inflammatory ointments and / or taking nonsteroidal anti-inflammatory drugs as particularly promising in the treatment of Sinding-Larsen's disease.

The homeopathy pursues various therapeutic approaches in the sense of a Overmoulding of the tendon sliding tissue with natural substances like Traumeel or Zeel. By carrying out conservative treatment methods alone, the course of the disease in Sinding-Larsen's disease can be restricted in most cases and the regeneration of the affected knee can be successfully stimulated. Only at about 10 percent of patients no success can be recorded despite a correspondingly long therapy.

In just these cases a operational intervention as the only possibility of healing. Various procedures are currently used in patients with Sinding-Larsen's disease, which can be carried out either individually or in combination. In order to reduce the load in the area of ​​the kneecap tip, this can Gliding tissue removed become. In addition, denervation of the tendon area, tendon loosening at the tip of the kneecap and removal of the dead bone tissue are particularly useful.

forecast

The prognosis for Sinding-Larsen's disease is at early diagnosis and rapid initiation of therapy very good. Affected patients must, however, avoid excessive strain on the kneecap tip even after treatment has been completed.

prevention

Sinding-Larsen's disease is a classic disease that occurs Overuse damage to the kneecap is due. For this reason, Sinding-Larsen's disease can also affect athletes through the Compliance with various measures can simply be prevented. Probably the most effective way of prevention is to carry out various Muscle stretching exercises before exercise. In addition, just people should get the sports Exercise, which are considered typical of the occurrence of Sinding-Larsen's disease, well before starting physical activity Warm up.

Since this type of bone necrosis can mainly be observed in people who have only recently had the Exercise of jumping sports have started, the slow increase in knee load as an effective preventive measure. Athletes with a tight schedule should always be outside of the training session enough time to regenerate plan on. In this way, hardening of the thigh muscles and excessive strain on the kneecap can be prevented.

Patients with known deformities of the Ankle joints, of the Knee joints or the hip should seek suitable orthopedic stores Sports insoles have it adjusted. In addition, every athlete should take the body's first warning signs seriously. If you have pain in your knees or hips, it should Activity level reduced immediately and, if necessary, a specialist is consulted.