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髌股关节:从发育异常到脱位

The patellofemoral joint: from dysplasia to dislocation.

作者信息

Zaffagnini Stefano, Grassi Alberto, Zocco Gianluca, Rosa Michele Attilo, Signorelli Cecilia, Marcheggiani Muccioli Giulio Maria

机构信息

Istituto Ortopedico Rizzoli, Dipartimento Rizzoli Sicilia, Bagheria (PA), Italy.

Istituto Ortopedico Rizzoli, Laboratorio di Biomeccanica e Innovazione Tecnologica, Bologna (BO), Italy.

出版信息

EFORT Open Rev. 2017 May 11;2(5):204-214. doi: 10.1302/2058-5241.2.160081. eCollection 2017 May.

Abstract

Patellofemoral dysplasia is a major predisposing factor for instability of the patellofemoral joint. However, there is no consensus as to whether patellofemoral dysplasia is genetic in origin, caused by imbalanced forces producing maltracking and remodelling of the trochlea during infancy and growth, or due to other unknown and unexplored factors.The biomechanical effects of patellofemoral dysplasia on patellar stability and on surgical procedures have not been fully investigated. Also, different anatomical and demographic risk factors have been suggested, in an attempt to identify the recurrent dislocators. Therefore, a comprehensive evaluation of all the radiographic, MRI and CT parameters can help the clinician to assess patients with primary and recurrent patellar dislocation and guide management.Patellofemoral dysplasia still represents an extremely challenging condition to manage. Its controversial aetiology and its complex biomechanical behaviour continue to pose more questions than answers to the research community, which reflects the lack of universally accepted guidelines for the correct treatment. However, due to the complexity of this condition, an extremely personalised approach should be reserved for each patient, in considering and addressing the anatomical abnormalities responsible for the symptoms. Cite this article: 2017;2. DOI: 10.1302/2058-5241.2.160081. Originally published online at www.efortopenreviews.org.

摘要

髌股发育不良是髌股关节不稳定的主要诱发因素。然而,对于髌股发育不良的起源尚无共识,其是源于遗传、婴儿期及生长过程中力的不平衡导致滑车轨迹不良和重塑,还是由其他未知和未探索的因素引起。髌股发育不良对髌骨稳定性及外科手术的生物力学影响尚未得到充分研究。此外,人们提出了不同的解剖学和人口统计学风险因素,试图识别复发性髌骨脱位患者。因此,对所有X线、MRI和CT参数进行综合评估有助于临床医生评估初次和复发性髌骨脱位患者并指导治疗。髌股发育不良仍然是一种极难处理的病症。其有争议的病因及其复杂的生物力学行为给研究界带来的问题多于答案,这反映出缺乏关于正确治疗的普遍接受的指南。然而,由于这种病症的复杂性,在考虑和处理导致症状的解剖学异常时,应为每位患者保留极其个性化的治疗方法。引用本文:2017;2。DOI:10.1302/2058 - 5241.2.160081。最初在线发表于www.efortopenreviews.org。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca03/5467684/611daa0ea966/eor-2-204-g001.jpg

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