Boden BP, Pearsall AW, Garrett WE, Feagin JA
Department of Orthopaedics, Duke University Medical Center, Durham, NC, at the time of this writing.
J Am Acad Orthop Surg. 1997 Jan;5(1):47-57. doi: 10.5435/00124635-199701000-00006.
Patellofemoral disorders are a common cause of knee pain and disability. A thorough history and a careful physical examination are essential to accurate diagnosis, and imaging modalities play an important role. Magnetic resonance imaging can provide information on malalignment and soft-tissue injuries. Although there is a continuum of diagnoses, most patellofemoral disorders can be divided into three distinct categories: soft-tissue abnormalities, patellar instability due to subluxation and dislocation, and patellofemoral arthritis. Many patellofemoral disorders respond to nonoperative therapy. When surgical intervention is necessary, patellar tilt can be successfully treated by a lateral release. Lateral patellar subluxation associated with malalignment can be corrected by a distal realignment procedure such as the anteromedial tibial tubercle transfer. Repair of the medial patellofemoral ligament in cases of patellar dislocation has considerably lowered the incidence of recurrent instability. Although no ideal treatment exists for patellofemoral arthritis, mechanical symptoms may be alleviated by arthroscopic debridement of delamination lesions. Articular cartilage-wear disorders may be stabilized by addressing the primary causative disorder.
髌股关节疾病是膝关节疼痛和功能障碍的常见原因。全面的病史采集和仔细的体格检查对于准确诊断至关重要，影像学检查也起着重要作用。磁共振成像可以提供有关对线不良和软组织损伤的信息。尽管诊断存在连续性，但大多数髌股关节疾病可分为三个不同类别：软组织异常、因半脱位和脱位导致的髌骨不稳定以及髌股关节炎。许多髌股关节疾病对非手术治疗有反应。当需要手术干预时，外侧松解术可成功治疗髌骨倾斜。与对线不良相关的外侧髌骨半脱位可通过远端重新对线手术（如胫骨结节内移术）进行矫正。髌骨脱位病例中髌股内侧韧带的修复已显著降低了复发性不稳定的发生率。尽管髌股关节炎尚无理想的治疗方法，但关节镜下对分层损伤进行清创可能会缓解机械性症状。通过处理原发性致病疾病，关节软骨磨损性疾病可能会得到稳定。
