Smith Toby O, McNamara Iain, Donell Simon T
Norwich Medical School and School of Rehabilitation Sciences, University of East Anglia, Norwich, NR4 7TJ UK.
Knee. 2013 Sep;20 Suppl 1:S3-S15. doi: 10.1016/S0968-0160(13)70003-6.
In this review the evidence for the management of patients with patellofemoral disorders is presented confined to anterior knee pain and patellar dislocation (excluding patellofemoral arthritis). Patients present along a spectrum of these two problems and are best managed with both problems considered. The key to managing these patients is by improving muscle function, the patient losing weight (if overweight), and judicious use of analgesics if pain is an important feature. Hypermobility syndrome should always be looked for since this is a prognostic indicator for a poor operative outcome. Operations should be reserved for those with correctable anatomical abnormalities that have failed conservative therapy. The current dominant operation is a medial patellofemoral ligament reconstruction.
在本综述中，针对髌股关节疾病患者的治疗证据仅限于膝前疼痛和髌骨脱位（不包括髌股关节炎）。患者表现出这两种问题的不同程度，最好在综合考虑这两个问题的情况下进行管理。治疗这些患者的关键在于改善肌肉功能、患者减重（如果超重），以及在疼痛是重要症状时合理使用镇痛药。应始终排查关节过度活动综合征，因为这是手术效果不佳的预后指标。手术应仅用于那些存在可纠正的解剖学异常且保守治疗失败的患者。目前主要的手术是内侧髌股韧带重建术。
