Video journal of sports medicine · 2025
Physical Examination for Patellofemoral Instability.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ignozzi Anthony J, Oley Matthew A, Diduch David R
Аннотация
BACKGROUND: We use 2 patient cases to demonstrate relevant physical examination findings when evaluating patients with patellofemoral instability.
INDICATIONS: Case 1 is a 19-year-old female college soccer player with multiple recurrent instability events. Case 2 is a young man in the military service, who is also 19 years old, who began having recurrent instability after a hard landing while skydiving.
TECHNIQUE DESCRIPTION: Normal patellar glide is 2 quadrants laterally and 1 quadrant medially; greater than 3 laterally indicates hypermobility. The moving apprehension test is performed with stepwise flexion to determine when the patellar engages the trochlea and no longer shifts laterally. It is important to ensure the quadriceps is relaxed. This test can help distinguish patellar instability from pain-related buckling. The jumping J sign is seen when the patella is completely disengaged from any bony restraint when going from flexion to extension of the knee.
RESULTS: On physical examination, both patients had positive effusion, tenderness, apprehension, and patellar tilt. Case 1 had an apprehension test positive to 80° of flexion, patellar mobility with a 2-quadrant shift laterally, and a soft J-sign. Case 2 instability was more prominent on examination with a moving apprehension test to 90°, a 4-quadrant shift laterally, and the prominent jumping "J" sign.
DISCUSSION/CONCLUSION: The physical examination, in addition to imaging, is essential for operative planning. For case 1, we proceeded with right knee tibial tubercle osteotomy, medial patellofemoral ligament reconstruction, lateral retinacular lengthening, and loose body removal. For case 2, we proceeded with right knee trochleoplasty, tibial tubercle osteotomy, medial patellofemoral ligament reconstruction, and lateral retinacular release.
PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
INDICATIONS: Case 1 is a 19-year-old female college soccer player with multiple recurrent instability events. Case 2 is a young man in the military service, who is also 19 years old, who began having recurrent instability after a hard landing while skydiving.
TECHNIQUE DESCRIPTION: Normal patellar glide is 2 quadrants laterally and 1 quadrant medially; greater than 3 laterally indicates hypermobility. The moving apprehension test is performed with stepwise flexion to determine when the patellar engages the trochlea and no longer shifts laterally. It is important to ensure the quadriceps is relaxed. This test can help distinguish patellar instability from pain-related buckling. The jumping J sign is seen when the patella is completely disengaged from any bony restraint when going from flexion to extension of the knee.
RESULTS: On physical examination, both patients had positive effusion, tenderness, apprehension, and patellar tilt. Case 1 had an apprehension test positive to 80° of flexion, patellar mobility with a 2-quadrant shift laterally, and a soft J-sign. Case 2 instability was more prominent on examination with a moving apprehension test to 90°, a 4-quadrant shift laterally, and the prominent jumping "J" sign.
DISCUSSION/CONCLUSION: The physical examination, in addition to imaging, is essential for operative planning. For case 1, we proceeded with right knee tibial tubercle osteotomy, medial patellofemoral ligament reconstruction, lateral retinacular lengthening, and loose body removal. For case 2, we proceeded with right knee trochleoplasty, tibial tubercle osteotomy, medial patellofemoral ligament reconstruction, and lateral retinacular release.
PATIENT CONSENT DISCLOSURE STATEMENT: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.