Ligamentitis (from the Latin ligamentum - ligament) - catarrhal changes in the ligaments due to frequent microtrauma, as well as as a consequence of the process of inflammation in nearby joints or under the influence of infection. The disease mainly affects women over 40 years of age, whose work activities involve heavy stress on the ligaments.
During the long course of the disease, degeneration of the ligaments occurs. The most common type of disease is ligamentitis of the hand, which is called “snapping finger.”
Treatment options
Treatment methods
The consequences of incorrectly chosen treatment tactics can be sad for the patient. He develops permanent disability. After the end of the acute period, the pain goes away. But instability of the joint remains. When the medial collateral ligament is torn, the knee easily tilts outward because there is no force holding the joint in the correct position. To be able to walk normally, a person fixes his knee either with a bandage or with special orthoses. But this only temporarily solves the problem. Over time, atrophy of the lower leg muscles develops, and long-term instability of the joint leads to gonarthrosis.
To avoid such problems in the future, the correct choice of treatment method is required. For this purpose, instrumental studies are carried out: not only X-rays, which allow us to establish the fact of a rupture, but also MRI, which provides the doctor with clarifying information. The patient is monitored after conservative treatment. If instability of the joint persists, it is operated on.
Causes of ligamentitis
Infantile ligamentitis occurs mainly due to the fact that some components of the hand go through stages of development over different time periods. This is what contributes to the faster development of tendons compared to the annular ligament on the fingers. Due to this discrepancy in growth, the ligaments interfere with the normal functioning of the tendons, on which thicker areas appear, and when the ligament passes through these areas, a click is created. Subsequently, the tendon loses its ability to slide easily, and the finger ceases to function normally.
In the adult population, the principle of the appearance of stenosing ligamentitis is the same. Occurs due to overload while working with hands. Rheumatism, arthritis, diabetes and gout also contribute to the appearance of ligamentitis.
Conservative treatment
The essence of conservative treatment is that the internal (tibial) ligament of the knee is provided with complete functional rest. As a result, the necessary conditions are created for the splicing of broken fibers. At the same time, during the acute period, there is a fight against symptoms (pain relief, elimination of swelling).
In the acute period, immediately after injury, the person is carefully examined. Typically, the lateral medial ligament is torn by a blow to the lateral aspect of the knee. Typically this is a sports injury. It may be accompanied by damage to other intra-articular structures (menisci, joint capsule, ligaments).
Sometimes surgery is performed shortly after injury. But if only the internal collateral ligament is damaged, conservative therapy is used. The knee is punctured, washed, and the blood is removed. Local anesthetics are injected internally to relieve pain. Typically 0.5% procaine is used. A plaster splint is applied for 1 week. After eliminating the swelling of the joint, it is changed to a circular plaster cast from the groin to the fingers.
When the medial collateral ligament of the knee joint is torn, the tibia is placed in an adducted position. This fixation ensures reduced mobility of the leg in the damaged joint. The position of the limb helps reduce the load on the injured ligament. It remains in a relaxed state for a long time, which ensures the normal course of regenerative processes.
About ligamentite
Ligamentitis is an inflammatory lesion of the ligaments that occurs as a result of infectious diseases or injuries. Ligamentitis is accompanied by pain in the area of the affected ligaments , a feeling of discomfort and decreased ability to work.
There are several types of ligamentite:
- Stenosing ligamentitis of the annular ligament of the hand (the so-called “snapping finger”);
- Stenosing ligamentitis of the palmar carpal ligament and transverse carpal ligament (carpal tunnel syndrome);
- Stenosing ligamentitis of the dorsal carpal ligament (de Quervain's disease);
- Ligamentitis of the knee joint and others.
For example, stenosing ligamentitis of the annular ligament of the hand (“snapping finger”) is a lesion of the ligaments, which is characterized by fixation of the finger in a bent position. It happens when the tendons responsible for the flexion movements of the finger are damaged. Ligamentitis of the knee joint is formed after injuries to this area, resulting in hemorrhage into adjacent ligaments. The formation of such a hematoma leads to inflammation of the ligaments and the development of ligamentitis. Ligamentitis of any localization requires proper treatment, the action of which will be aimed at restoring the ligaments and eliminating the inflammatory process.
physiotherapy
physiotherapy
Additional treatment methods:
- physiotherapy – many methods are used that can improve blood circulation in the joint, accelerate the elimination of swelling, and normalize regenerative processes;
- physical therapy - static gymnastics is prescribed from the third day, in the recovery period (after removing the cast) they move on to dynamic exercises aimed at strengthening the muscles of the limb;
- arthrotherapy - injections of hyaluronate and platelet-rich plasma into the joint, accelerate tissue regeneration and prevent cartilage degeneration.
Symptoms of ligamentitis
The symptoms of ligamentitis are similar, despite the fact that damage to the ligaments can be localized in completely different parts of the human body (be it the ligaments of the hand, elbow or knee).
Symptoms of ligamentitis are as follows:
- Pain in the area of the affected ligament, which manifests itself during movement;
- Increased sensitivity;
- Contractures may appear;
- Decreased mobility in the joint whose ligaments are affected;
- Numbness of the finger;
- The appearance of swelling over the joint whose ligaments are affected.
There are characteristic symptoms for ligamentitis of various localizations . So, for example, with stenosing ligamentitis of the annular ligament of the hand, there will be pain in the finger when flexing and extending, a characteristic clicking in the finger when moving, pain when pressing on the palm.
If the above symptoms appear, it is better not to hesitate and immediately seek help from specialists.
Surgery
Surgical treatment of a rupture of the internal ligament of the knee is required if it is completely torn, if instability of the joint persists. It can be partially compensated with the help of special restrictive orthopedic devices. However, sooner or later the disease will cause gonarthrosis and muscle atrophy. Therefore, the earlier surgery is performed, the better the results.
Ligament plastic surgery
There are several ways to stabilize a knee when the medial ligament is torn. One of them is plastic. The material for it is an autograft. That is, tissues of the human body that are similar in their properties are taken. They are implanted at the site of the torn ligament. Often, a fragment of the fascia lata of the thigh is taken for this purpose.
Autoplasty with the tendon of the tender muscle is used. In the area of the medial epicondyle of the femur, the osteoperiosteal cusp is formed. A tendon is placed under it. The sash is then strengthened with sutures. The wound is sutured. The limb is immobilized with a plaster cast for 4 weeks. The bandage is applied from the upper third of the thigh to the toes. In this case, the knee should be bent at an angle of 170 degrees.
Ligament suture
Often this operation is performed in the acute period of injury - no later than 8 days after receiving it. It can also be carried out within the first three days. That is, almost immediately after the injury, although swelling and hematoma still persist. Early intervention improves surgical results.
When the superficial layer of the medial collateral ligament of the knee ruptures, the rupture site is sutured. The doctor discovers a hematoma at the site of the rupture. In addition, he can detect this place by abducting and adducting the lower leg: the ends diverge. The doctor stitches the ligament in the transverse direction, covering 1 cm above and below the damaged area. After this, the ligament is stitched longitudinally along its entire length. When a bone fragment is torn off, it is fixed with a screw and washer.
After surgery, the limb is immobilized with an orthosis. Duration – up to one and a half months. In the postoperative period, a person is prescribed antibiotics and painkillers. In most cases, within 3 months after surgery, a person’s lameness completely disappears, and after 6 months, the function of the joint is completely restored.
Treatment of ligamentitis
Treatment of ligamentitis must begin with identifying the cause that could lead to the development of this disease. In our clinic, doctors use modern diagnostic methods that help make a diagnosis quickly and accurately. When contacting a specialist, he will collect the necessary medical history data, conduct an objective examination, and, using modern methods of functional diagnostics, make the correct diagnosis. After clarifying the etiology of ligamentitis, our specialists will be able to prescribe you the most effective treatment, which will be aimed at eliminating symptoms, eliminating inflammatory damage to the ligaments, and will also allow you to forget about the disease in the shortest possible time.
Treatment of ligamentitis can be conservative and surgical . Conservative treatment includes immobilization (limb, joint), physiotherapeutic procedures, and drug therapy.
Immobilization is necessary to reduce the mobility of the limb or joint to which the affected ligaments are attached. A fixed position, creating complete rest for the affected ligaments will speed up their healing. Immobilization is necessary for a period of at least 2 weeks.
Among the physiotherapeutic procedures for the treatment of ligamentitis, paraffin applications, mud, and ozokerite are widely used.
It should be noted that massage in the area of the affected ligaments is not recommended. Anti-inflammatory drugs, as well as glucocorticosteroids, are actively used in drug therapy. Injections of hydrocortisone (or its analogues) are carried out directly into the area of the affected ligaments. Hydrocortisone reduces the inflammatory process in this area, relieves pain and leads to rapid healing and restoration of ligaments. In addition to glucocorticoids, today the PRP method is actively used to treat ligamentitis . This is enriched autologous human platelet plasma. This method is safer than the use of glucocorticoids. The PRP method has an anti-inflammatory, healing, analgesic effect. If conservative therapy does not bring the expected results, it is necessary to resort to surgical treatment of ligamentitis.
treatment of ligamentitis at the highest level in our clinic. Here you can get advice from experienced traumatologists. Our specialists select treatment and diagnostic methods on an individual basis. In our clinic, doctors are professionals in their field, working at the highest level, while achieving the best results and maximum success.
Why does stenosing ligamentitis form?
The reasons that the finger begins to click may vary in its pathogenesis:
1. Selected area of professional activity. This disease is often a consequence of frequently repeated movements of the fingers in one direction. As a result, a kind of tendon blocking effect occurs. People who fall into the “risk group” for the occurrence of this disease are milkmaids (with the exception of machine milking operators), hairdressers, manicurists and pedicurists, masons, musicians, seamstresses, etc.).
2. Hereditary factor. It cannot be called the main cause of the development of stenosing ligamentitis. However, isolated cases of inherited predisposition to the disease have been recorded.
3. Congenital defect. We are talking about an abnormal structure of the tendon-ligamentous apparatus of the hand, which can only be corrected by surgical intervention.
4. Injury. After a bruise or sprain in the arm without further examination by a doctor, stenosing ligamentitis may develop.
5. Chronic diseases. Symptoms of the disease are sometimes difficult to recognize in time against the background of existing pathologies such as arthritis or rheumatism. The disease can also develop due to diabetes mellitus, atherosclerosis and thyroid dysfunction.
6. Physiological and age-related changes. This factor especially concerns pregnant women and women at the onset of menopause, in whom, due to hormonal changes, water is retained in the synovial membrane.
7. Systemic autoimmune changes. Stenosing ligamentitis can be triggered by scleroderma, lupus erythematosus, polymyositis, Sharp, Weber-Christian and Sjögren's syndromes.
Causes of ligamentitis of the knee joint
As a rule, ligamentitis of the patellar ligament and other components of the ligamentous apparatus in the knee area occurs for several reasons:
- traumatic knee injury of varying severity;
- some inflammatory diseases, such as brucellosis;
- sedentary lifestyle;
- strong pressure on the lower leg, excessive physical stress on the knee.
In older people, knee ligamentitis can cause calcification. Inflammation of the lateral ligaments often develops at a young age, as well as in those who play sports professionally or lead an active lifestyle.
Any knee ligament can become inflamed
Methods for diagnosing ligamentitis
Ligamentitis of the knee and patella, as well as a similar disease of the annular ligament of the hand, can be detected through a visual examination by a specialist. You should definitely contact him if you have pain and other disturbing symptoms. X-rays and MRIs can provide more accurate information about the condition of the knee. Also, in some cases, additional information can be provided by puncture, arthroscopy and ultrasound.
Failure to properly treat inflammation of the knee and patella can lead to irreversible consequences. The ligaments are transformed, which negatively affects the functioning of the joint. And the acute type of the disease can become chronic.
Diagnosis of the disease
Specialists who treat the hand for this type of dysfunction are an orthopedist and a traumatologist. To make a diagnosis, multifaceted diagnostics are not needed. All the doctor needs to do is examine the patient’s hand and gently palpate it.
Such manipulations are necessary to detect the area of inflammation, which feels like a lump to the touch. If there are no assumptions about the presence of degenerative-dystrophic changes in the joints, then the specialist will refer the patient for an x-ray.
To confirm the development of a pathological process in the body, the need to undergo some laboratory tests is not excluded. Usually, the doctor needs to analyze a general blood test, which, if leukocytes and ROE are elevated, will confirm the presence of inflammation in a person.