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patella alta - Coggle Diagram
patella alta
patella在femoral bone太上面
常跟PFPS、髕骨軟化、patella OA有關聯
Etiology
Sports injury
congenital condition(天生的)
過長的patella tendon(>52 mm or patella tendon lenght/patella bone length>1.2)
characteristic
differential diagnosis
Patellofemoral instability
Recurrent patellofemoral dislocation
Neuromuscular diseases (poliomyelitis)
Spastic cerebral palsy
Osgood Schlatter disease
Sinding Larsen Johanssen disease
Patella tendo-lateral femoral condyle friction syndrome
Chondromalacia patella
examination
patellar apprehension test
patellar glide test
有dislocation的人不要做
lateral glide>medial glide
treatment
tibial tuberosity osteotomy(骨頭切除術)
將patella tendon往tibia遠端一點連接，髕骨就可以往下一點
因有patella alta的患者Q angle會增加，可將patella tendon往tibia內側一點移，降低Q angle
透過taping或bracing改善patellar tracking，但效果有限
非手術性治療
急性期
冰敷消腫
SLR 15~20次，5 sets訓練quadriceps
knee imobilization讓組織修復，但最近提倡在knee上戴brace，去掉immbolization的階段
亞急性期
飛輪執行passive and active ROM
isometric and isotonic excercise
加強VMO肌力
慢性期:3~8周
可以回到正常活動，如果tenderness下降且兩腿quadriceps肌力相等