Panni Alfredo Schiavone, Cerciello Simone, Vasso Michele
Dipartimento di Medicina e Scienze per la salute, Università degli Studi del Molise, Campobasso.
Joints. 2013 Jun 12;1(1):34-9. eCollection 2013 Mar.
Instability of the patella is a relatively frequent occurrence in adolescents. Its pathogenesis, which is multi-factorial, is still much debated. Stability of the patella is guaranteed by a delicate balance of a series of factors (osteo-cartilaginous, ligamentous and muscular), and it is not surprising that alteration of one or more of these can lead to pathological conditions that can range from simple anterior pain associated with a hypermobile patella to recurrent dislocation. The aim of surgical treatment is to correct these anatomical abnormalities. Surgical procedures on the soft tissues comprise reefing, realignment and reconstruction of the medial stabilizing structures, and release of the lateral structures. These procedures, although having precise indications, provide the surgeon with the instruments necessary to deal with almost all these anatomo-pathological conditions. Furthermore, preserving the osteo-cartilaginous components results in less morbidity than is associated with traditional surgical procedures, such as trochleoplasty and transposition of the anterior tibial tuberosity.
髌骨不稳定在青少年中较为常见。其发病机制是多因素的，仍存在诸多争议。髌骨的稳定性由一系列因素（骨软骨、韧带和肌肉）的微妙平衡来保证，因此其中一个或多个因素发生改变会导致病理状况，从与髌骨活动过度相关的单纯前侧疼痛到复发性脱位，也就不足为奇了。手术治疗的目的是纠正这些解剖异常。软组织手术包括内侧稳定结构的折叠、重新排列和重建，以及外侧结构的松解。这些手术尽管有确切的适应症，但为外科医生提供了应对几乎所有这些解剖病理状况所需的手段。此外，保留骨软骨成分比传统手术（如滑车成形术和胫骨结节前移术）导致的发病率更低。
