Carstensen S Evan, Menzer Heather M, Diduch David R
Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA.
Sports Med Arthrosc Rev. 2017 Jun;25(2):92-99. doi: 10.1097/JSA.0000000000000150.
Trochleoplasty is a very effective procedure for correcting trochlear dysplasia and addressing instability of the patella. With an increasing knowledge about the anatomy and biomechanics of the anterior distal femur, a wider array of surgical techniques may be applied to address specific conditions. Patients must be carefully selected to undergo trochleoplasty by use of a thorough history and physical examination as well as basic and advanced imaging. The presence of a "J sign" on physical examination, a history of recurrent instability, patella alta, trochlear dysplasia, and elevated tibial tubercle to trochlear groove are signs and symptoms for which the patient should be evaluated. We attempt to elucidate when trochleoplasty is indicated by means of addressing all aspects of evaluation.
滑车成形术是矫正滑车发育不良和解决髌骨不稳定的一种非常有效的手术方法。随着对股骨远端前部解剖学和生物力学的认识不断增加，可以应用更广泛的手术技术来处理特定情况。必须通过全面的病史、体格检查以及基础和高级影像学检查来仔细挑选适合接受滑车成形术的患者。体格检查中出现“J征”、复发性不稳定病史、髌骨高位、滑车发育不良以及胫骨结节至滑车沟抬高都是应对患者进行评估的体征和症状。我们试图通过探讨评估的各个方面来阐明何时需要进行滑车成形术。
