Patellar instability and patellofemoral dysfunction Flashcards
what causes patellar dislocation
direct blow or sudden twist to the knee
in what direction does the patella almost always dislocate
laterally
describe how patellar dislocation is resolved
may spontaneously reduce when straightened or rarely may require to be manually manipulated back into position
what pathology occurs when the patella dislocates
the medial patellofemoral ligament tears, osteochondral fracture can occur, lipo-haemarthrosis
when would patellar dislocation result in osteochondral fracture
when the medial facet of the patella strikes the lateral femoral condyle
what are the predisposing factors to patellar dislocation
ligamentous laxity, female, shallow trochlear groove, genu valgum, femoral neck anteversion or high riding patella
what treatment can be used if patellar dislocation is recurrent
tibial tubercle transfer or medial patellofemoral ligament reconstruction with tendon autograft
describe what patellofemoral dysfunction is
disorders of patellofemoral articulation that cause anterior knee pain
give some examples of diagnosis that come under patellofemoral dysfunction
chondromalacia patella, adolescent anterior knee pain, lateral patellar compression syndrome
describe the pathophysiology of patellofemoral dysfunction
quadricep muscle tends to pull patella in slight lateral direction, excessive lateral force can cause anterior knee pain and lateral facet of patella is compressed against lateral wall of distal femoral trochanter
what are some predisposing factors to patellofemoral dysfunction
joint hypermobility, genu valgum and femoral neck anteversion
what clinical features are seen with patellofemoral dysfunction
anterior knee pain, worse going downhill, a grinding or clicking sensation at front of knee and stiffness after prolonged sitting causing “pseudolocking”
what is the main treatment for patellofemoral dysfunction, used in 90% patients
physiotherapy
when would surgery be used for patellofemoral dysfunction and what does it involve
either releasing a tight lateral retinaculum, or a tibial tubercle transfer to aid patellar tracking
