McGee Terrence G, Cosgarea Andrew J, McLaughlin Kevin, Tanaka Miho, Johnson Ken
Departments of *Physical Medicine and Rehabilitation †Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.
Sports Med Arthrosc Rev. 2017 Jun;25(2):105-113. doi: 10.1097/JSA.0000000000000147.
Patellar instability resulting from subluxation or dislocation is a painful and commonly recurring condition. Retinacular restraints control patellar tracking, limiting the movement of the patella in the trochlear groove. The medial patellofemoral ligament (MPFL) is considered the main soft tissue stabilizer against lateral displacement. Few studies of patellar instability discuss rehabilitation after MPFL reconstruction. In this review, we discuss the phases of rehabilitation after MPFL reconstruction, typical interventions by rehabilitation specialists, and patient-specific guidelines for return to prior level of function. The Musculoskeletal Institute at The Johns Hopkins Hospital (a collaboration of orthopedic surgeons, primary care sports medicine physicians, and clinicians from the Department of Physical Medicine and Rehabilitation) presents its rehabilitation protocol with phase-specific guidelines for progression after MPFL reconstruction. This evidence-based protocol is a generalized approach that is customized for each patient's needs.
由半脱位或脱位引起的髌骨不稳定是一种疼痛且常见的复发性病症。支持带约束控制髌骨轨迹,限制髌骨在滑车沟内的移动。髌股内侧韧带(MPFL)被认为是防止外侧移位的主要软组织稳定器。很少有关于髌骨不稳定的研究讨论MPFL重建后的康复问题。在本综述中,我们讨论了MPFL重建后的康复阶段、康复专家的典型干预措施以及恢复到先前功能水平的患者特定指南。约翰霍普金斯医院的肌肉骨骼研究所(由骨科医生、初级保健运动医学医生以及物理医学与康复科的临床医生合作组成)展示了其康复方案,其中包含MPFL重建后各阶段的进展指南。这一基于证据的方案是一种通用方法,会根据每个患者的需求进行定制。