Papp Kata, Speth Bernhard M, Camathias Carlo
Department of Traumatology and Orthopaedic Surgery, Kantonsspital Aarau, CH-5000 Aarau, Switzerland.
Department of Orthopaedic Surgery, University Children's Hospital Basel, CH-4031 Basel, Switzerland.
J Pers Med. 2023 Aug 9;13(8):1240. doi: 10.3390/jpm13081240.
Patellofemoral instability is a prevalent cause of pain and disability in young individuals engaged in athletic activities. Adolescents face a particularly notable risk of patellar dislocation, which can be attributed to rapid skeletal growth, changes in q-angle, ligamentous laxity, higher activity levels, and increased exposure to risk. Specific sports activities carry an elevated risk of patellar dislocation. Younger age and trochlear dysplasia present the highest risk factors for recurrent patellar dislocations. International guidelines recommend conservative therapy following a single patellar dislocation without osteochondral lesions but suggest surgical intervention in recurrent cases. In this study, we have compiled current scientific data on therapy recommendations, focusing on MPFL (medial patellofemoral ligament) reconstruction. We discuss patient selection, surgical indications, graft selection, location and choice of fixation, graft tensioning, and postoperative care.
髌股关节不稳是从事体育活动的年轻人疼痛和残疾的常见原因。青少年面临着髌股关节脱位的特别显著风险，这可归因于骨骼快速生长、Q角变化、韧带松弛、活动水平较高以及暴露于风险中的机会增加。特定的体育活动会增加髌股关节脱位的风险。年龄较小和滑车发育不良是复发性髌股关节脱位的最高风险因素。国际指南建议，对于首次髌股关节脱位且无骨软骨损伤的情况采用保守治疗，但对于复发性病例则建议进行手术干预。在本研究中，我们汇编了有关治疗建议的当前科学数据，重点关注内侧髌股韧带（MPFL）重建。我们讨论了患者选择、手术指征、移植物选择、固定的位置和选择、移植物张紧以及术后护理。
