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一名31岁女性髌骨脱位合并内侧半月板部分撕裂及早期骨关节炎保守治疗后骨科康复的新颖之处

The Novelty of Orthopedic Rehabilitation After Conservative Management for Patellar Dislocation With Partial Tear of Medial Meniscus and Early Osteoarthritis in a 31-Year-Old Female.

作者信息

Tiwari Pooja R, Patil Deepali S, Sasun Anam R, Phansopkar Pratik

机构信息

Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2023 Sep 30;15(9):e46298. doi: 10.7759/cureus.46298. eCollection 2023 Sep.

Abstract

Primary patellar dislocation or first-time patellar dislocation is the second most frequent cause of knee injuries which overall accounts for about 3% of other knee injuries. The patellofemoral joint is formed by the patella connecting to the femoral trochlea and creates both static and dynamic structures of the knee. There are basically three types of patellar dislocation: superior, lateral, and medial. The lateral dislocation is the most frequent one. Females are more vulnerable and are at higher risk than males. Muscular weakness or muscular imbalance leads to patellar instability, and ultimately to dislocation. The recurrence rate after primary patellar dislocation is 15-60%. This case report is of a 31-year-old female with patella dislocation with a medial meniscal tear and a case of early osteoarthritis for whom we planned goal-oriented physiotherapy rehabilitation week-wise and progressed every week. The assessment was taken before and after physiotherapy rehabilitation. The patient was managed conservatively with a long knee brace, and physiotherapy started after one month. Due to prolonged immobilization, the patient suffered from quadriceps muscle atrophy. The physiotherapist focused on biomechanism and got the expected results in pain reduction, regaining strength, and improving range of motion, and the patient was able to walk properly without taking any support after rehabilitation.

摘要

原发性髌骨脱位或首次髌骨脱位是膝关节损伤的第二大常见原因,总体约占其他膝关节损伤的3%。髌股关节由髌骨与股骨滑车连接而成,构成膝关节的静态和动态结构。髌骨脱位基本上有三种类型:向上脱位、向外侧脱位和向内侧脱位。向外侧脱位最为常见。女性比男性更易患病,风险更高。肌肉无力或肌肉失衡会导致髌骨不稳定,最终导致脱位。原发性髌骨脱位后的复发率为15%至60%。本病例报告的是一名31岁女性,患有髌骨脱位并伴有内侧半月板撕裂以及早期骨关节炎,我们为其制定了以目标为导向的每周理疗康复计划,并每周推进。在理疗康复前后进行了评估。患者通过佩戴长腿支具进行保守治疗,一个月后开始理疗。由于长期固定,患者出现了股四头肌萎缩。物理治疗师关注生物力学,在减轻疼痛、恢复力量和改善活动范围方面取得了预期效果,康复后患者无需任何支撑就能正常行走。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67c0/10616635/829c9fd17eb5/cureus-0015-00000046298-i01.jpg

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