Hoff's disease (lipoarthritis) is the degeneration of the surrounding knee joint of adipose tissue, manifested by restriction of joint mobility, crunching, swelling, discomfort, pain and lameness. In the absence of timely competent treatment of Goff's disease, the "fat pad" ceases to fulfill its buffer function and the disease gradually flows into a chronic stage. Also, lipoarthritis can be transformed into arthrosis of the knee, provoking over the years permanent articular pain
Goff's disease is the cause
Most often, with Hoff's disease, the fat body is damaged in the area of the pterygoid folds. The fatty body is usually damaged in case of a knee injury, when the fat lumps are trapped and damaged, hemorrhage and the subsequent swelling of the tissues. At the site of damage, there is a proliferation of fibrous tissue, which, despite the replacement of the lost tissue, can not perform the function of fat tissue. In some cases, Goff's disease develops under the influence of hormonal factors (menopause in women), or against the background of knee arthrosis.
Very often, the causes of the development of this disease are: a very minor injury of the knee joint, prolonged pressure on the front surface of the knee joint, inflammation of the knee joint. Hoff's disease usually occurs in women after forty-five years, which is associated with a violation of the hormonal background (pre- and postmenopausal periods)
Hoff's disease - symptoms
This disease has a rather characteristic clinical picture: swelling of the joint in the lower anterior section, incomplete extension of the joint without the expressed interest of the ligamentous apparatus and menisci, hypotrophy , pseudoflu- curating crepitations on either side of the patellar ligament, functional instability of the knee joint, decreased function of the inner head of the quadriceps femoris .
The prevalence and severity of Goff's disease is also indicated by the fact that among all the recorded cases of severe violations of the functioning of the lower extremities due to some orthopedic pathology, the severity of functional disorders caused by Hoff's disease is about 12%.
The first symptoms of Hoff's disease, indicating damage to the fatty body, is the weakness of the quadriceps muscle, swelling in the palpation, and pain in the knee. In case of a chronic form of the disease, the signs are not always sufficiently definable, therefore, such additional examinations as MRI and CT are often carried out. Common symptoms of diseases of the knee joint include: true and false joint blockages, limited mobility, swelling, discomfort and pain in the joint area. Hyperplasia of the fat body often leads to fibrosis of the synovial membrane.
When performing X-ray examination, signs of stages I-II of arthrosis of the knee joint are observed, which seems to be the causative basis for setting the wrong diagnosis. The arthropneumograms clearly indicate the presence of characteristic changes: the regurgitation of the upper curvature and the decrease in the volume of the knee joint, the increased volume of the posterior turn with the development of the hernial protrusion into the popliteal region (Becker cyst), the hypertrophy of fatty tissue with its introduction between the tibial and femur bones is observed in the lower patellar region . On x-ray images, calculous bursitis is often determined in the area of the pterygoid folds. Against the background of the permanent trauma of the synovial bag, Hoff's disease acquires a chronic course
Hoff's disease - treatment
In the case of timely diagnosis, it is enough to perform anti-inflammatory therapy for recovery, with subsequent rehabilitation. The treatment of Hoff's disease in the early stages is carried out with the help of hormonal preparations of prolonged action, which can significantly reduce inflammation. A good effect is provided by laser therapy, massage and physiotherapy. In case of ineffectiveness of this complex treatment and further progression of the disease, surgical intervention is shown - resection of the fatty body of Hoff. Arthroscopy is performed to damage damaged and fibrous tissue. A persistent positive effect in the treatment of Hoff's disease is given by laser treatment, corticosteroids are used to reduce inflammation.
The therapy of Goff's disease is carried out in stages and involves the restoration of the supporting function of the foot, the elimination of inflammation of the knee joint, the restoration of the working capacity of the leg muscles and the restoration of the motor function of the leg. To strengthen the muscles-flexors of the lower leg, the patient is prescribed therapeutic exercises and therapeutic walking.
In case of relapse, the therapeutic course of treatment should be repeated. Additionally, a massage and an electrostimulation course are usually prescribed. Especially shown massage in case of atrophy of the quadriceps muscle of the thigh. Methods of carrying out the massage are as follows: vibrating rubbing and stroking the base of the palm. The main tasks of massage - pain relief, prevention of muscle atrophy of the hip, improvement of blood flow and lymph flow.
After the surgical intervention, during the recovery period, patients are recommended to take radon, sulphide and iodide-bromine baths. In addition, visiting resorts with sulphide waters - Gagra, Sochi, Pyatigorsk, Matsesta - is recommended; and such balneological resorts as Maykop, Nalchik, Kudepsta.