Lussazioni traumatiche acute di rotula
Abstract
ACUTE TRAUMATIC PATELLAR DISLOCATION
Acute patellar dislocation is a common knee injury that occurs most often in adolescents, frequently associated with
sport and physical activities. Two-thirds of acute patellar dislocations occur in young active patients less than 20 years
old. Non-contact knee sprain in flexion and valgus is the leading mechanism for patellar dislocation, accounting for as
many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and mostly the
medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently
at its femoral attachment. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation
and plan correction. MRI gives the best information on cartilage and capsulo-ligamentous status for treatment
planning: free bodies or osteochondral fracture should be treated surgically. Acute patellar dislocation is associated
with a high rate of recurrent patellar instability, instability symptoms and, eventually, patellofemoral osteoarthritis.
A consensus on its management is still lacking. Though most authors have reported good results with conservative
treatment, a surgical approach would be necessary in the presence of severe cartilage damage or a relevant disruption
of the medial stabilizers with instability and subluxation of the patella.
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© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2018 , 2018
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