复发性髌骨脱位中J征的发生机制与临床诊疗进展
The Mechanism and Clinical Advances in Diagnosis and Treatment of the J-Sign in Recurrent Patellar Dislocation
DOI: 10.12677/acm.2026.1651797, PDF,   
作者: 付 平*, 林西贝, 李会榕：昆明医科大学第二附属医院骨科，云南 昆明；方绍然, 陶 莹：云南省滇东北中心医院创伤外科，云南 昭通；王建婷：四川省绵阳市江油市雁门镇中心卫生院，四川 江油
关键词: 复发性髌骨脱位；J征；滑车发育不良；放射评估；手术治疗；Recurrent Patellar Dislocation； J-Sign； Trochlear Dysplasia； Radiological Assessment； Surgical Treatment
摘要: 复发性髌骨脱位(Recurrent Patellar Dislocation, RPD)中的J征是反映髌骨轨迹不良的直观动态体征，也是决定患者远期生活质量的关键预后因素之一。其发病机制并非单一软组织力学失衡，而是股骨滑车发育不良、高位髌骨、下肢三维旋转畸形及软组织张力失衡共同作用的结果。传统临床视触觉评估信度较低，目前广泛推荐基于多角度动态CT的三维影像学量化参数(如BOI、PTG等)进行精准评估。在手术策略抉择上，高度J征是内侧髌股韧带重建术(Medial Patellar Ligament Reconstruction Surgery, MPFLR)术后复发的高危因素。因此，临床需依托精准的影像学诊断，制定包含内侧髌胫韧带联合重建、下肢去旋转截骨及股骨滑车成形术在内的个性化联合手术方案，以彻底纠正解剖异常，改善患者预后。
Abstract: The J-sign in recurrent patellar dislocation (RPD) is an intuitive dynamic sign reflecting patellar maltracking and a key prognostic factor determining patients’ long-term quality of life. Its pathogenesis is not merely a result of soft tissue mechanical imbalance but a combined consequence of trochlear dysplasia, patella alta, three-dimensional rotational deformities of the lower extremity, and soft tissue tension imbalance. Traditional clinical visual and tactile assessments have low reliability. Currently, precise evaluation based on three-dimensional imaging quantitative parameters derived from multi-angle dynamic CT scans (such as BOI, PTG, etc.) is widely recommended. Regarding surgical strategy selection, a high-grade J-sign is a significant risk factor for recurrence after isolated medial patellar ligament reconstruction surgery (MPFLR). Therefore, clinical practice necessitates relying on precise imaging diagnosis to formulate personalized combined surgical plans, including combined medial patellotibial ligament reconstruction, lower extremity derotational osteotomy, and trochleoplasty, to thoroughly correct anatomical abnormalities and improve patient outcomes.
文章引用：付平, 林西贝, 李会榕, 方绍然, 陶莹, 王建婷. 复发性髌骨脱位中J征的发生机制与临床诊疗进展[J]. 临床医学进展, 2026, 16(5): 125-130. https://doi.org/10.12677/acm.2026.1651797

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