Reider B, Marshall J L, Warren R F
Am J Sports Med. 1981 Jul-Aug;9(4):270-4. doi: 10.1177/036354658100900419.
The clinical histories of 50 young athletes who complained of patellar instability or pain were analyzed, and their physical findings were compared to those of 50 controls. The patients were divided into three groups, based on their symptoms. Analysis of their physical findings confirmed the validity of these divisions. Those who complained of frank dislocation of the patella exhibited the most pronounced stigmata of quadriceps dysplasia, including vastus medialis deficiency and infrapatellar fat pad enlargement, and had increased general ligamentous laxity, increased mean patellar mobility, and out-facing patellae with concomitantly decreased Q angles in chronic, recurrent cases. Patients who complained of the classic patellar pain pattern, often called "chondromalacia patella," but who denied swelling were designated CMP. They had normal mean ligamentous laxity and mean patellar mobility, an increased incidence of in-facing patellae with concomitantly increased mean Q angle, and frequently palpable lateral patellofemoral bands. Patients who complained of pain and swelling had physical findings intermediate to the other two groups, and generally correspond to what is usually termed subluxation of the patella. They exhibited normal general laxity but increased mean patellar mobility, normal mean Q angle but an increased incidence of patellar infacing, and fat pad enlargement.
分析了50名主诉髌骨不稳定或疼痛的年轻运动员的临床病史，并将他们的体格检查结果与50名对照者的结果进行了比较。根据症状将患者分为三组。对他们体格检查结果的分析证实了这些分组的有效性。那些主诉髌骨明显脱位的患者表现出股四头肌发育异常最明显的体征，包括股内侧肌缺损和髌下脂肪垫增大，并且在慢性复发性病例中存在全身韧带松弛增加、平均髌骨活动度增加、髌骨向外以及Q角随之减小。主诉典型的髌骨疼痛模式（常称为“髌骨软化症”）但否认肿胀的患者被指定为CMP。他们的平均韧带松弛度和平均髌骨活动度正常，髌骨向内的发生率增加且平均Q角随之增加，并且经常可触及外侧髌股韧带。主诉疼痛和肿胀的患者的体格检查结果介于其他两组之间，通常对应于通常所称的髌骨半脱位。他们表现出全身松弛度正常但平均髌骨活动度增加，平均Q角正常但髌骨向内的发生率增加，以及脂肪垫增大。
