Patellar dislocation

　　Patellar dislocation often occurs during running (especially when turning or twisting), semi-squatting lateral displacement (defensive step in basketball), or lateral impact of the knee joint, etc., which are direct traumas. Some patients with patellar dislocation may have their own anatomical abnormalities, such as systemic joint capsule relaxation, high patella, genu varum (X-shaped leg) and other manifestations.

　　Pathological damage:

　　Most patellar dislocations are lateral dislocations. After dislocation, the stable structures on the medial side of the patellofemoral joint, including the medial patellofemoral ligament, the adductor muscle of the femur, and the medial patellofemoral ligament, are all torn, leading to hemarthrosis and synovitis in the knee joint cavity; during the process of spontaneous复位, the medial side of the patella collides with the lateral side of the femoral condyle, which can cause cartilage injury or tangential fracture.

　　Recurrent patellar dislocation and late patellar subluxation can be complicated with osteoarthritis.

　　Osteoarthritis (osteoarthritis) is a common joint disease, whose main lesions are degenerative changes of joint cartilage and secondary bone hyperplasia, more common in middle-aged and elderly people, and more common in women than in men. Osteoarthritis is prone to affect the distal and proximal interphalangeal joints of the hands, knees, elbows, shoulders, and spinal joints, while the wrist and ankle joints are less prone to disease.

　　Patients may feel sudden severe pain in the knee joint, with a feeling of dislocation or weakness. After the knee joint is extended, the patella often automatically复位 itself, and a 'click' sound can often be heard during复位. Subsequently, the knee joint becomes swollen and painful. These symptoms may be confused with meniscus tear, but unlike meniscus tear, the patients with patellar dislocation can feel swelling and pain on the medial edge of the patellofemoral joint, not on the medial gap of the knee joint.

　　The prevention of this disease mainly focuses on traumatic causes of dislocation, avoiding trauma is the key to the prevention and treatment of this disease. In addition, attention should be paid to both effectively correcting the dislocation and maintaining the normal patellofemoral joint structure during correction, keeping the patellofemoral joint fit normal, without postoperative knee pain and patellofemoral arthritis, and fast functional recovery. Pay attention to daily diet maintenance and active prevention.

　　1, Imaging examination

　　Routine knee anteroposterior and lateral radiographs are very necessary, 30-degree flexion lateral radiographs, to observe whether there is a high patella; take 30-degree or 45-degree patellar axis radiographs (Merchant position) or CT scans, which can find patellar lateral subluxation. The most ideal examination method is MRI, which can clearly show patellofemoral subluxation, knee effusion, and can also judge whether there is accompanying femoral condyle cartilage injury or other joint internal structure injury.

　　2, Physical examination

　　It is very important, including patellar mobility examination and patellar flexion knee fear test, which can directly judge whether there is patellar instability.

　　1, Peanut, red bean, jujube, and garlic soup

　　Formula: 90 grams of peanuts with the skin, 60 grams of red beans and jujube; 30 grams of garlic.

　　Preparation: Boil all the ingredients together in water to make a soup.

　　Usage: Take in the morning and evening.

　　2, Chinese lily and clam soup

　　Formula: Clam meat 30 grams, Chinese lily 15 grams, loofah 10 grams.

　　Preparation: Boil the above three ingredients in appropriate water, and add salt for taste.

　　Usage: Drink the soup and eat the meat, once a day, use for 10 days.

　　3. Fishy bean kelp soup

　　Formula: Green beans 30g, kelp 20g, Houttuynia cordata 15g.

　　Preparation: Boil the above three ingredients in water, remove the Houttuynia cordata, and add appropriate sugar for taste.

　　Usage: Drink the soup and eat the beans and kelp. Once a day, take for 7 days.

　　4. Green bean lily Job's tears porridge

　　Formula: Job's tears 50g, mung beans 25g, fresh lily 100g.

　　Preparation: Peel the lily, remove the inner membrane, add water to cook mung beans and Job's tears to five maturity, then add lily, cook porridge with slow fire, and add sugar for taste.

　　Usage: Once or twice a day.

　　The treatment of habitual patellar dislocation is better when the age is younger. It can not only solve the dislocation problem but also prevent secondary deformities. If the treatment is delayed, it may lead to secondary deformities such as hip and knee joint flexion, increased lumbar anterior convexity, and even knee osteoarthritis, affecting work and life. Practice has proven that surgical treatment can achieve significant effects. There are many surgical methods, and they can be summarized as follows.

　　1. Soft tissue surgery, including: tension suture of the medial knee fascia, joint capsule, and expanded part of the quadriceps muscle. Fascia transfer surgery (Campbell), medial fascia, and muscle pedicle transfer surgery (Krougius). Tendon transfer surgery, transferring the medial hamstring muscle to strengthen the internal pull force of the hamstrings.

　　2. Surgery at the lower end of the femur for patients with internal rotation of the lower end of the femur, genu varum, and poor development of the femoral condyle, respectively perform femoral condylar osteotomy, and femoral condyle elevation surgery (Albee).

　　3. Patellar ligament transfer surgery (Houser) performs unilateral patellar ligament transfer surgery (Goldthwait) in children.

　　4. Patellofemoral joint osteotomy to reshape the patella, deepen the patellar trochlear notch, and pad the surrounding soft tissue between them. Meng Jimo proposed that habitual patellar dislocation has different local structural developmental deformities, which cannot be solved by a single surgery. Comprehensive surgical treatment should be adopted according to different deformities, and the transfer of the adductor magnus muscle is advocated to strengthen the internal traction force.