Dejour David H, Mazy David, Pineda Tomas, Cance Nicolas, Dan Michael J, Giovannetti de Sanctis Edoardo
EFORT Open Rev. 2025 Jun 2;10(6):378-387. doi: 10.1530/EOR-2025-0051.
Patellar dislocations present predominantly during adolescence, with a higher incidence observed among female patients. Patellofemoral joint stability depends critically on both osseous anatomy and soft tissue structures. Patellofemoral pathology can be classified into three major groups: objective patellar instability OPI, potential patellar instability and painful patellar syndrome. Three primary risk factors predispose individuals to patellar dislocation: trochlear dysplasia, patella alta and increased tibial tuberosity-trochlear groove (TT-TG) distance. Three secondary risk factors should be considered: femoral and tibial rotational abnormalities and valgus deformity. MRI has become the imaging modality of choice, enabling precise quantification of OPI risk factors in a single imaging examination. The 'menu à la carte' approach guides the treatment of OPI by addressing the most relevant anatomical risk factors for each patient using statistical thresholds.
髌骨脱位主要发生在青春期，女性患者的发病率更高。髌股关节稳定性主要取决于骨性解剖结构和软组织结构。髌股关节病变可分为三大类：客观髌骨不稳定（OPI）、潜在髌骨不稳定和疼痛性髌骨综合征。有三个主要危险因素使个体易发生髌骨脱位：滑车发育不良、髌骨高位和胫骨结节-滑车沟（TT-TG）距离增加。还应考虑三个次要危险因素：股骨和胫骨旋转异常以及外翻畸形。MRI已成为首选的成像方式，能够在一次成像检查中精确量化OPI危险因素。“点菜式”方法通过使用统计阈值针对每位患者最相关的解剖学危险因素来指导OPI的治疗。
