Recurrent patellar dislocation

　　1. Etiology

　　After acute patellar dislocation, the medial patellar retinaculum is relaxed and weak; the lateral patellar retinaculum is contracted; genu varum and genu recurvatum deformities, etc.

　　2. Pathogenesis

　　Recurrent patellar dislocation is often caused by one or several factors after acute dislocation. These factors include: relaxation or weakness of the medial patellar retinaculum; contraction of the lateral patellar retinaculum; genu varum deformity; genu recurvatum deformity; increased anterior tilt of the femoral neck or internal rotation of the femur; external rotation of the tibia; the patellar tendon being inserted outward at the tibial tuberosity; and winged patella or high-riding patella. Additional factors include atrophy of the medial quadriceps muscle, as well as joint laxity of the whole joint, etc.

　　Recurrent patellar dislocation may be complicated with osteoarthritis in the late stage. Osteoarthritis is mainly characterized by joint pain, which occurs during activity and disappears or improves after rest. During an acute attack, the pain intensifies, and symptoms such as joint swelling, joint stiffness, and joint friction sound may occur. Some patients may feel joint pain after staying in a certain position for a long time, or when getting out of bed in the morning, which is called rest pain. After a certain period of joint movement, the pain disappears, and the joint may feel relaxed.

　　In cases of habitual dislocation caused by congenital etiology, there are no effective preventive measures for the disease. Therefore, the prevention of this disease mainly focuses on traumatic etiology-induced dislocation, and avoiding trauma is the key to the prevention and treatment of the disease. In addition, attention should also be paid to both effectively correcting the dislocation during orthopedic correction and maintaining the normal patellofemoral joint structure as much as possible, keeping the patellofemoral joint alignment normal, and not leaving knee pain and patellofemoral arthritis after surgery, with a quick recovery of function.

　　1, MRI examination of bones and joints;

　　2, CT examination of bones and joints and soft tissues;

　　3, CT examination of the limbs;

　　4, Patellar separation test;

　　5, Brain CT examination;

　　6, Anteroposterior, lateral, and 30° patellar axis X-ray films of the bilateral knees are helpful to show the semi-luxation tendency between the patella and the femoral trochlea.

　　First, therapeutic diet for recurrent patellar luxation(The following information is for reference only, detailed information needs to be consulted with a doctor)

　　1, Coix Seed Porridge:

　　30g Coix seed, 10g papaya, 60g glutinous rice, 2 spoons of sugar. Wash the Coix seed and papaya, pour them into a small pot, add glutinous rice and two bowls of cold water, soak for a moment, then simmer over low heat until the Coix seed is soft and tender, add sugar, and simmer a little longer, eat daily, no restrictions on quantity. It has the effects of removing wind and dampness, relaxing tendons and relieving pain.

　　2, Pork Eel Soup:

　　250g eel, 100g pork, 15g Du Zhong, scallions, ginger, cooking wine, vinegar, and pepper in appropriate amounts. Decoct Du Zhong, remove the dregs, and reserve the juice; kill the eel, remove the intestines and clean it, blanch it with boiling water, scrape off the sticky substances on the outer skin, and cut into segments. Cut the pork into pieces, stir-fry in a pot with oil, add water and Du Zhong juice, then add the eel segments, scallions, ginger, and cooking wine, bring to a boil, then simmer over low heat until the fish is tender, add vinegar and pepper, remove from heat, sprinkle with coriander, and serve with meals. It has the effects of tonifying the liver and kidneys, benefiting the Qi and blood, and removing wind and collateral blockages.

　　3, Pig's Hoof Mahonia Drink:

　　1 pig's hoof, 100g Mahonia fortunei. Clean the pig's hoof of impurities and hair, add 3000ml of water with Mahonia fortunei, and simmer over low heat, then strain to get 1000ml of juice. Divide it into 5 servings for hot drinking, twice a day. The pig's hoof can also be eaten. It has the effects of promoting blood circulation, removing blood stasis, and strengthening tendons and bones.

　　4, Ox Tendon Soup:

　　100g ox tendons, 15g Danggui, Danshen, mushrooms, and ham, ginger, scallion whites, Shaoxing wine, monosodium glutamate, and salt in appropriate amounts. Wash the ox tendons with warm water, bring 500g of water to a boil, add 15g of lye, pour in the tendons, cover the lid, and steam for two minutes, then remove with hot water to wash off the oil污; repeat multiple times until the tendons swell and can be processed. Cut the swollen tendons into segments, place them in a steaming bowl, put Danggui and Danshen in a gauze bag around the edges, arrange mushrooms and ham on top, add ginger, scallion whites, and seasonings, then steam for about 3 hours until the tendons are tender, then remove the medicine bag, scallions, and ginger, and serve with meals. It has the effects of promoting blood circulation, nourishing the blood, and relaxing the tendons and collaterals.

　　5, Astragalus Snake Soup:

　　Astragalus 60g, snake meat 1000g,续断10g, ginger 15g, cooked pork 30g, cooking wine, pepper, salt, and scallion whites in appropriate amounts. First, cut off the head and tail of the snake, remove the internal organs and clean it, then cut into slices; wash Astragalus and Xu Duàn with cold water to remove floating ash and impurities, and then soak in clean cold water for 1 hour. Heat a wok over high heat, add 30g lard, stir-fry the snake meat after the oil is hot, add cooking wine, then pour the snake meat into a pot, add ginger slices, scallion whites, and salt, and simmer over low heat for 1 hour. Add pepper and remove the scallions and ginger, then serve with meals. It has the effects of tonifying the liver and kidneys, benefiting the Qi and blood, and removing dampness and wind.

　　Second, what foods are good for the body with recurrent patellar dislocation

　　1. Nutritional meal planning: The staple food for patients with femoral head necrosis should be rice, noodles, and mixed grains, with a combination of coarse and fine. In addition, you should eat more fresh vegetables and fruits to supplement the necessary vitamins and minerals for the human body. You can also eat some seafood, fish, and shrimp, which contain a lot of calcium and phosphorus to supplement the needs of the human body.

　　2. Dairy products: In ordinary food, dairy products have the highest calcium content, such as milk, yogurt, ice cream, etc. They not only contain a large amount of calcium but also rich in another important mineral for the human body - phosphorus. The calcium-phosphorus ratio in these dairy products is moderate, which allows for the full absorption of calcium and phosphorus and other substances. Milk also contains proteins, lactose, and other substances. If you drink 2 cups of milk (about 480 milliliters) every day, it is enough to meet the calcium needs of adults.

　　3. Bone broth: Bone broth also contains fatty acids and proteins, among which fatty acids include saturated and unsaturated fatty acids, which are important substances for bone formation.

　　4. Eat more foods that can be converted into organic bone gelatin: such as lean meat, fish, eggs, and bean products.

　　Third, what foods should be avoided for recurrent patellar dislocation

　　1. Avoid spicy, hot, and greasy foods, especially not to take rich and nourishing foods too early.

　　2. Quit smoking, drinking, and other stimulant beverages.

　　Actively treat the primary disease, prevent trauma, and treat the patellar dislocation after acute dislocation in a timely manner. Acute dislocation, if non-surgical treatment is used, manual reduction is often possible once it occurs. By extending the knee joint, squeezing the lateral edge of the patella can realign the dislocated patella. Then, the thigh cast is fixed for 4 to 6 weeks. It is also necessary to carefully examine with X-rays to exclude the presence of bone cartilage fragments remaining in the joint. It is as far as possible to avoid recurrent patellar subluxation or complete dislocation in the future. However, it should be noted that conservative treatment methods often ignore the injury to the medial patellar ligament and cannot correct developmental patellar malposition or patellofemoral alignment. When there are bone cartilage fragments in the knee joint, surgical excision or repair should be performed, and the torn soft tissues on the medial side of the knee, including the medial part of the quadriceps femoris, must be repaired during surgery.