[Radiologic assessment of femoro-patellar instability. Personal experience and review of the literature].

摘要: Purpose To propose a simple and reproducible radiological evaluation of patellofemoral instability to enable the orthopaedic surgeon choose best therapy. Material methods We have evaluated retrospectively radiographs CT examinations 25 patients, 15 female 10 male, aged between 18 32 years. They underwent surgical treatment for patellar in past 4 Lateral retinacular release has been performed every patient, medial transposition anterior tibial tuberosity 23 patients 5 them also its distal replacement, proximal Insall's realignement was 20 cases only 1 patient trochleoplasy. Preoperative conventional included antero-posterior view, true lateral view (exact superimposition posterior trochlear edges) axial views at 30 degrees knee flexion. On height based on Caton-Deshamps index dysplasia assessed using suggested by Dejour. A examination both knees performed: images were taken first with extension, without quadriceps contraction, then flexion degrees. Patellar "bascule" angles measured relaxed contracted as an dysplasia; TAGT extension degree position tuberosity. findings compared those obtained postoperatively 30.4 months from intervention. Results All free complaints after surgery. In high patella corrected different severity present all it not modified treatment, exception who trochleoplasty. realignment, angles--pathological before surgery--were restored normal values 3 cases. tuberosity, normalized: nevertheless, three low found surgery this condition may predispose development iperpression syndrome. Conclusions suffering instability, protocol which includes two projections supplies information needed evaluating mobility, dysplasia, valgism excessive Careful such abnormalities is important selecting each patient. It's simple, quick, accurate that be reproduced, even radiographic equipment. The collaboration radiologist crucial correct interpretation findings, must together clinical so adequate therapeutical plan could proposed.