The Research And Treatment Advances In Patella Instability

Patella instability is a kind of common patellofemora disease, it refers to the degree of patella extraversion or moving outward increases when the knee-joint extend and flex. The clinically common symptoms such as anterius genu pain and chondromalacia patella are mostly related to patella instability, and just doing simple symptomatic treatment couldn't eliminate the basic pathogeny. It usually attacks again and again, makes further damage of patellar cartilage and results in infernal circle. So the key point of treating this kind of disease is diagnosing and treating it as early as possible, making clear the pathogenetic reason, re-establishing the circum-patellar stabilization mechanism, rectifying the skeletal dysplasia and restoring patellar stability to the limit. But patellar stability involves many factors, including the motion trail of patella, patellofemora contact, Q angle, the balance of soft tissue and the skeletal developmental condition. The pathogeny is comparatively complex, so at present, the operative modes used to treat patella instability are various, about more than one hundred kinds. It could be divided into two kinds generally: the soft-tissue ones and the osseous ones. The effects of the operations are different, and the key point is to use corresponding operative modes according to different cause of the disease and restore patellar stability as far as possible. So during the recent years, the internal and international scholars have done a series of study about the stabilization mechanism and the treating methods of the patellofemoral joint. They explored from the aspect of anatomic observation and biomechanics, tried many operative modes, applied them jointly to treat patellar instability, and received satisfactory result. Especially with the development of the arthroscopic technique, now the treatment of patellar instability inclines to microtrauma care. While relieving clinical symptoms, it more focuses on the functional recovery and the prognosis result of the disease. This article does a overview mainly from the aspect of patellofemoral stabilization mechanism and its treating progress.