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髌股疼痛综合征病因与治疗的研究进展

         

摘要

Patellofemoral pain syndrome (PFPS) is one of the most common diseases that cause pain in the knee joint. At present,there is no specific diagnostic measure. The diagnosis of patellofemoral pain syndrome may be considered when imag-ing is performed without cartilage,ligament and soft tissue injuries. The etiology includes abnormalities of the patellar motion caused by various anatomical abnormalities,such as abnormal patellar position,increased Q angle,and excessive valgus foot. Dysfunction of the lower extremity muscles such as the imbalance of the four biceps and the dysfunction of the gluteal muscles also play an important role in the development of patellofemoral pain syndrome. At present,there are many treatments,and the exercises of four biceps exercises and hip abductor exercises are aimed at improving the dynamic stability of patella;The mus-cle patch and the patellar brace mainly reduce the pressure of the patellofemoral joint by improving the patellar trajectory;Foot orthopedic pads are used primarily in patients with valgus feet. After the conservative treatment is ineffective ,the patellar later-al retinaculum can be loosened under arthroscopy. Because the patellofemoral pain syndrome is caused by the combined effects of various etiologies,a variety of treatments are helpful to improve the therapeutic effect.%髌股疼痛综合征(patellofemoral pain syndrome,PFPS)是导致膝关节疼痛最为常见的疾病之一.目前无特异性诊断措施,影像学检查无软骨、韧带及软组织损伤表现时方可考虑诊断为髌股疼痛综合征.其病因包括各种解剖结构异常导致的髌骨运动轨迹异常,如髌骨位置异常、Q角增大及足过度外翻等,股四头肌失衡和臀肌功能异常等下肢肌肉功能异常同样在髌股疼痛综合征的发生发展中起重要作用.目前存在多种治疗方式,股四头肌锻炼和臀外展肌锻炼目的在于改善髌骨动态稳定性;肌效贴和髌支具主要通过改善髌骨轨迹,减轻髌股关节面间的压力;足矫形垫主要用于伴有足外翻的患者;在保守治疗无效后,可考虑进行膝关节镜下松解髌骨外侧支持带术.由于髌股疼痛综合征为多种病因综合作用而致病,同时采用多种治疗方式有助于提高治疗效果.

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