Severino Nilson Roberto, Severino Fabrício Roberto, de Camargo Osmar Pedro Arbix, Guglielmetti Luiz Gabriel Betoni, de Oliveira Victor Marques, Cury Ricardo de Paula Leite
Grupo de Joelho, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de São Paulo, São Paulo, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Apr;56(2):147-153. doi: 10.1055/s-0040-1713389. Epub 2020 Nov 2.
Patellar instability is a multifactorial clinical condition that affects a significant number of patients and occurs due to morphological variations of the joint and patellofemoral alignment. The present literature review study aimed to identify and summarize current concepts on patellar instability, in relation to associated risk factors, diagnostic criteria, and the benefits and risks of conservative and surgical treatments. For this purpose, a search was conducted in the following electronic databases: MEDLINE (via Pubmed), LILACS and Cochrane Library. It is concluded that the accurate diagnosis depends on the detailed clinical evaluation, including the history and possible individual risk factors, as well as imaging exams. The initial treatment of patellar instability is still controversial, and requires the combination of conservative and surgical interventions, taking into consideration both soft tissues and bone structures, the latter being the most common reason for choosing surgical treatment, especially lateral patellar instability.
髌骨不稳定是一种多因素的临床病症,影响着大量患者,其发生是由于关节的形态变异和髌股关节对线异常。本综述性文献研究旨在识别和总结有关髌骨不稳定的当前概念,涉及相关危险因素、诊断标准以及保守治疗和手术治疗的利弊。为此,在以下电子数据库中进行了检索:医学文献数据库(通过PubMed)、拉丁美洲和加勒比地区卫生科学数据库以及考克兰图书馆。得出的结论是,准确的诊断取决于详细的临床评估,包括病史和可能的个体危险因素,以及影像学检查。髌骨不稳定的初始治疗仍存在争议,需要综合保守治疗和手术干预,同时考虑软组织和骨骼结构,后者是选择手术治疗的最常见原因,尤其是外侧髌骨不稳定。