Mistry Jaydev B, Bonner Kevin F, Gwam Chukwuweike U, Thomas Melbin, Etcheson Jennifer I, Delanois Ronald E
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland.
Department of Orthopedic Surgery and Sports Medicine, Jordan-Young Institute, Virginia Beach, Virginia.
J Knee Surg. 2018 May;31(5):439-447. doi: 10.1055/s-0037-1604142. Epub 2017 Jul 18.
The medial patellofemoral ligament (MPFL) is thought to be the most important medial structure providing restraint to lateral subluxation of the patella. After an initial patellar dislocation, the MPFL is frequently injured and can usually be treated with conservative measures. However, these patients often suffer from recurrent dislocations, which thereby necessitate operative intervention. In the setting of normal anatomy and kinematics, isolated reconstruction of the MPFL is an effective treatment for preventing recurrent dislocations. Various surgical techniques have been described, with differences in fixation and graft selection. The treatment of MPFL injuries should aim to provide patellar stabilization and restore normal kinematics throughout the joint. This review will discuss the following: (1) anatomy of the MPFL, (2) presentation and assessment of MPFL injuries, (3) management of patients with MPFL injuries, and (4) complications following MPFL reconstruction.
髌股内侧韧带(MPFL)被认为是对髌骨向外侧半脱位提供约束的最重要的内侧结构。初次髌骨脱位后,MPFL常受损伤,通常可采用保守治疗措施。然而,这些患者常遭受复发性脱位,因此需要手术干预。在正常解剖结构和运动学情况下,孤立地重建MPFL是预防复发性脱位的有效治疗方法。已经描述了各种手术技术,在固定和移植物选择方面存在差异。MPFL损伤的治疗应旨在提供髌骨稳定并恢复整个关节的正常运动学。本综述将讨论以下内容:(1)MPFL的解剖结构,(2)MPFL损伤的表现和评估,(3)MPFL损伤患者的管理,以及(4)MPFL重建后的并发症。