Stanitski C L, Paletta G A
Department of Orthopaedics, Children's Hospital of Michigan, Detroit 48201, USA.
Am J Sports Med. 1998 Jan-Feb;26(1):52-5. doi: 10.1177/03635465980260012501.
Acute patellar dislocation and relocation produces major forces at the articular surfaces. Articular injury was assessed in 48 patients, 24 boys and 24 girls (mean age, 14 years), with acute, initial, noncontact patellar dislocations. Correlation of the findings of radiographic and arthroscopic examinations was done. Eleven of the 48 patients (23%) had radiologic diagnoses of articular injuries. Thirty-four of the 48 patients (71%) had arthroscopic evidence of articular damage, 32 osteochondral and 2 chondral injuries. Eight of the 28 (29%) arthroscopically identified osteochondral loose bodies (4 to 20 mm) were identified radiologically. Overall, only 11 of the 34 (32%) arthroscopically documented articular injuries were defined by preoperative radiographs. These standard radiographs provided limited information for management decisions. Poor results after patellar dislocation treatment may involve nonrecognition of articular compromise.
急性髌骨脱位及复位会在关节面产生巨大力量。对48例急性、初次、非接触性髌骨脱位患者(24名男孩和24名女孩,平均年龄14岁)的关节损伤情况进行了评估。对X线检查和关节镜检查结果进行了相关性分析。48例患者中有11例(23%)经放射学诊断有关节损伤。48例患者中有34例(71%)有关节镜检查证实的关节损伤证据,其中32例为骨软骨损伤,2例为软骨损伤。28例经关节镜检查发现的骨软骨游离体(4至20毫米)中有8例经放射学检查发现。总体而言,术前X线片仅能确定34例经关节镜记录的关节损伤中的11例(32%)。这些标准X线片为治疗决策提供的信息有限。髌骨脱位治疗效果不佳可能与未认识到关节损伤有关。