Bistolfi Alessandro, Massazza Giuseppe, Backstein David, Ventura Stefano, Cerlon Raul, Crova Maurizio
Department of Orthopaedics and Traumatology, CTO Hospital, Via Zuretti 29, 10126 Turin, Italy.
Case Rep Med. 2012;2012:182795. doi: 10.1155/2012/182795. Epub 2012 Jan 11.
Congenital permanent dislocation of the patella is a rare disorder of the knee joint in which the patella is permanently displaced, even in extension and is fixed on the lateral aspect of the femoral condyle. The dislocation is irreducible without surgical techniques. This rare condition is usually detected within the first decade of life, because of inability of active extension in the knee and impaired ability during walking. This report presents an unusual case of a 51-year-old man with bilateral congenital permanent dislocation of the patella. The pathology had never been treated because there were few symptoms. The patient presented with right knee pain caused by a fall on the knee during his work. The right knee was painful on the lateral side and the clinical signs were positive for pathology of the lateral meniscus, confirmed by MRI. The clinical and the imaging findings suggested a lesion of the lateral meniscus as the probable cause of the pain. Therefore we performed a knee arthroscopy, whose intra-operative findings confirmed the MRI findings. During the surgery we performed just a selective arthroscopic meniscectomy, without correcting patella dislocation, because the condition was unusually asymptomatic before the trauma.
先天性髌骨永久性脱位是一种罕见的膝关节疾病,其中髌骨即使在伸直时也处于永久性移位状态,并固定在股骨髁的外侧。若无手术技术,这种脱位无法复位。由于膝关节主动伸直功能障碍及行走能力受损,这种罕见病症通常在生命的第一个十年内被发现。本报告介绍了一例不同寻常的病例,一名51岁男性患有双侧先天性髌骨永久性脱位。由于症状轻微,该病变从未接受过治疗。患者因工作时膝盖摔倒而出现右膝疼痛。右膝外侧疼痛,临床体征显示外侧半月板病变呈阳性,MRI检查证实了这一点。临床和影像学检查结果提示外侧半月板损伤可能是疼痛的原因。因此,我们进行了膝关节镜检查,术中发现证实了MRI检查结果。手术期间,我们仅进行了选择性关节镜半月板切除术,未纠正髌骨脱位,因为在创伤前该病症异常无症状。