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膝关节脱位合并髌股关节脱位:一项系统评价

Knee dislocation with concomitant patellofemoral dislocation: A systematic review.

作者信息

McKeeman Jonathan, Lee Ryan, Smith Tyler

机构信息

Department of Orthopaedic Surgery, St. Luke's University Health Network, 801 Ostrum St., Bethlehem, PA, 18015, USA.

出版信息

J Orthop. 2024 Oct 19;62:84-89. doi: 10.1016/j.jor.2024.10.025. eCollection 2025 Apr.

Abstract

BACKGROUND

There is no consensus treatment for knee dislocations with associated patellar dislocation. This systematic review provides an overview of current treatments and the authors preferred treatment algorithm. Knee dislocation with concomitant patellar dislocation is a rare occurrence and there is no standard of care for these injuries. This review seeks to provide a systematic review of literature and a proposed treatment algorithm for this injury pattern.

METHODS

A systematic review was performed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines using the PubMed, MEDLINE, and Cochrane databases in July 2024. Studies were assessed for human patients who sustained a knee dislocation with concomitant patellar dislocation.

RESULTS

The literature search yielded 288 titles and abstracts to be screened. Of the 288 articles, 281 titles and abstracts were excluded. Ultimately six full text articles were included. There were three case reports/series of acute knee dislocation with associated patellar dislocation and there were three case reports of chronic knee dislocation with associated patellar dislocation. In all studies, patellar instability was addressed surgically regardless of patient risk factors.

CONCLUSION

Knee dislocation with associated patellar dislocation is a rare occurrence, but in general can be treated with the standard of care for a knee dislocation and then an assessment of risk factors for consideration of MPFL repair or reconstruction.

LEVEL OF EVIDENCE

Level 4- systematic review of case reports and case series.

摘要

背景

对于伴有髌骨脱位的膝关节脱位,目前尚无共识性的治疗方法。本系统评价概述了当前的治疗方法以及作者推荐的治疗方案。伴有髌骨脱位的膝关节脱位较为罕见,对于这类损伤尚无标准的治疗方案。本综述旨在对相关文献进行系统评价,并针对这种损伤模式提出治疗方案。

方法

2024年7月,按照PRISMA(系统评价和Meta分析的首选报告项目)指南,使用PubMed、MEDLINE和Cochrane数据库进行了系统评价。纳入对伴有髌骨脱位的膝关节脱位患者的研究。

结果

文献检索共得到288篇标题和摘要以供筛选。其中281篇标题和摘要被排除。最终纳入6篇全文文章。有3篇关于急性膝关节脱位伴髌骨脱位的病例报告/系列,以及3篇关于慢性膝关节脱位伴髌骨脱位的病例报告。在所有研究中,无论患者的风险因素如何,均通过手术解决髌骨不稳定问题。

结论

伴有髌骨脱位的膝关节脱位较为罕见,但一般可采用膝关节脱位的标准治疗方法,然后评估风险因素,以考虑是否进行内侧髌股韧带修复或重建。

证据级别

4级——病例报告和病例系列的系统评价。

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本文引用的文献

1
Patellofemoral Instability Part I: Evaluation and Nonsurgical Treatment.髌股关节不稳定 第一部分:评估与非手术治疗。
J Am Acad Orthop Surg. 2022 Nov 15;30(22):e1431-e1442. doi: 10.5435/JAAOS-D-22-00254. Epub 2022 Aug 29.
2
Triple dislocation around the knee joint: a case report.膝关节三联脱位 1 例报告。
J Med Case Rep. 2022 Jan 7;16(1):7. doi: 10.1186/s13256-021-03201-w.
7
Neglected rotatory knee dislocation: A case report.陈旧性旋转性膝关节脱位:一例报告。
Knee. 2014 Oct;21(5):975-8. doi: 10.1016/j.knee.2014.04.006. Epub 2014 Apr 18.

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