Lesiones de cartílago de rótula en dislocación rotular recurrente. (Inglés)

Las lesiones del cartílago de la rótula en la dislocación rotular recurrente.

Eiki Nomura, MD*, and M. Inoue, MD From the Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, Kawasaki, Japan, and the Department of Orthopaedic Surgery, Isehara-Kyodo Hospital, Isehara, Japan
* Address correspondence to Eiki Nomura, Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, 12-1, Shinkawa-dori, Kawasaki-ku, Kawasaki, 210-0013, Japan

Background: The etiology of patellar cartilage lesions in recurrent patellar dislocation has been poorly understood.

Hypothesis: The pathology of cartilage lesions of the patella accompanied by recurrent patellar dislocation can be analyzed.

Study Design: Series of case reports.

Methods: In 70 knees from 57 patients with recurrent patellar dislocation, the cartilage lesions of the patella were examined using arthroscopy and/or macroscopic observation. The average age of the patients was 22 years (range, 13 to 40 years). Lesions that involved only softening were not included.

esults: Sixty-seven knees (96%) had articular cartilage lesions of the patella, and only 3 knees had no change. Fissuring was observed in 53 knees (76%). The most common site of fissuring was on the central dome. There were basically two types of fissuring: multiple longitudinal fissuring and marginal/radial fissuring. Fibrillation and/or erosion were observed in 54 knees (77%). Of these, 40 knees had fissuring and 14 did not have fissuring. The main site of fibrillation and/or erosion was the medial facet.

Conclusions: Cartilage lesions of the patella in recurrent patellar dislocation cases were very common. Fissuring was observed mainly on the central dome, and fibrillation and/or erosion were observed mainly on the medial facet.

Key Words: cartilage • patella • dislocation • chondromalacia • fissure

The American Journal of Sports Medicine 32:498-502 (2004)