Manske Robert C, Prohaska Daniel
Int J Sports Phys Ther. 2017 Jun;12(3):494-511.
Patellar instability is a common problem seen by physical therapists, athletic trainers and orthopedic surgeons. Although following an acute dislocation, conservative rehabilitation is usually the first line of defense; refractory cases exist that may require surgical intervention. Substantial progress has been made in the understanding of the medial patellofemoral ligament (MPFL) and its role as the primary stabilizer to lateral patellar displacement. Medial patellofemoral ligament disruption is now considered to be the essential lesion following acute patellar dislocation due to significantly high numbers of ruptures following this injury. Evidence is now mounting that demonstrates the benefits of early reconstruction with a variety of techniques. Recently rehabilitation has become more robust and progressive due to our better understanding of soft tissue reconstruction and repair techniques. The purpose of this manuscript is to describe the etiology of patellar instability, the anatomy and biomechanics and examination of patellofemoral instability, and to describe surgical intervention and rehabilitation following MPFL rupture.
髌股关节不稳定是物理治疗师、运动训练师和骨科医生常见的问题。虽然急性脱位后，保守康复通常是第一道防线；但存在难治性病例可能需要手术干预。在对髌股内侧韧带（MPFL）及其作为髌骨向外侧移位的主要稳定器的作用的理解方面已经取得了实质性进展。髌股内侧韧带断裂现在被认为是急性髌骨脱位后的关键损伤，因为这种损伤后有大量的断裂。现在越来越多的证据表明了各种技术早期重建的益处。由于我们对软组织重建和修复技术有了更好的理解，最近康复变得更加有力和进步。本手稿的目的是描述髌股关节不稳定的病因、髌股关节不稳定的解剖学、生物力学和检查，并描述MPFL断裂后的手术干预和康复。
5级。
