From the Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada (Pauyo), the Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada (Dr. Park) the Faculty of Medicine, McGill University, Montréal, Québec, Canada (Bozzo), Shriners Hospital for Children-Canada, Montreal Quebec (Pauyo, Bernstein), and the Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada (Bernstein).
J Am Acad Orthop Surg. 2022 Nov 15;30(22):e1431-e1442. doi: 10.5435/JAAOS-D-22-00254. Epub 2022 Aug 29.
Patellofemoral instability (PFI) is a prevalent cause of knee pain and disability. It affects mostly young females with an incidence reported as high as 1 in 1,000. Risk factors for instability include trochlear dysplasia, patella alta, increased tibial tubercle-to-trochlear groove distance, abnormal patella lateral tilt, and coronal and torsional malalignment. Nonsurgical and surgical options for PFI can treat the underlying causes with varied success rates. The goal of this review series was to synthesize the current best practices into a concise, algorithmic approach. This article is the first in a two-part review on PFI, which focuses on the clinical and radiological evaluation, followed by nonsurgical management. The orthopaedic surgeon should be aware of the latest diagnostic protocol for PFI and its nonsurgical treatment options, their indications, and outcomes.
髌股关节不稳定(PFI)是引起膝关节疼痛和功能障碍的常见原因。它主要影响年轻女性,发病率高达每 1000 人中就有 1 例。不稳定的危险因素包括滑车发育不良、高位髌骨、胫骨结节至滑车沟距离增加、髌骨外侧倾斜异常以及冠状面和扭转对线不良。髌股关节不稳定的非手术和手术治疗方法可以针对潜在病因进行治疗,但成功率有所不同。本综述系列的目的是将当前的最佳实践综合为一个简洁的、按算法处理的方法。本文是髌股关节不稳定两部分综述的第一部分,重点介绍了临床和影像学评估,接下来是非手术治疗。骨科医生应该了解髌股关节不稳定的最新诊断方案及其非手术治疗选择、适应证和结果。