Artículos
Publicado el 5 de agosto de 2001
Patología patelar
Desalineamiento patelar
Revisión de la evolución histórica del conocimiento de esta disfunción mecánica de la rótula y de su implicancia en la capacidad funcional articular de la rodilla.
Autor/a: Ronald Grelsamer, M.D.
Es una desviación translatoria y rotatoria de la rótula en relación a su eje y puede ser uno de los mayores componentes del dolor patelar en los adultos. El término condromalacia que se suele utilizar como definición patológica de esta sintomatología, genera no poca confusión, ya que la patología condral no es el factor principal del dolor y su gradación no está claramente establecida, por lo que resultaría más útil su descripción cuantitativa ( ej.: ampollada, fisurada) y cualitativa (en términos de tamaño, localización y profundidad).
El término subluxación patelar, tambien es confuso, ya que puede corresponder a un síntoma, un hallazgo clínico o una observación radiográfica, requiriendo por lo tanto la explicación pertinente en cada caso.
![IntraMed](data:image/svg+xml,<?xml version="1.0" encoding="UTF-8"?>%0A<svg id="Capa_1" xmlns="http://www.w3.org/2000/svg" version="1.1" viewBox="0 0 1080 315">%0A <defs>%0A <style>%0A .st0 {%0A fill-rule: evenodd;%0A }%0A%0A .st0, .st1 {%0A fill: %23002bc7;%0A }%0A%0A .st2 {%0A fill: %23fff;%0A }%0A </style>%0A </defs>%0A <g>%0A <circle class="st2" cx="141.5" cy="179.93" r="135.02"/>%0A <g>%0A <path class="st2" d="M350.28,126.97v106.62c0,7-4.04,11.22-10.41,11.22s-10.5-4.22-10.5-11.22v-106.62c0-7,4.13-11.22,10.5-11.22s10.41,4.22,10.41,11.22Z"/>%0A <path class="st2" d="M459.96,184.86v49.09c0,6.82-4.04,10.86-10.23,10.86s-10.14-4.04-10.14-10.86v-47.03c0-13.28-6.73-20.28-20.73-20.28-7.81,0-15.53,2.15-20.19,4.85v62.47c0,6.82-4.04,10.86-10.23,10.86s-10.14-4.04-10.14-10.86v-66.68c0-6.37,1.35-9.24,7.09-12.21,5.38-3.14,18.49-8.17,33.48-8.17,26.66,0,41.11,14.36,41.11,37.96Z"/>%0A <path class="st2" d="M505.83,137.92v10.68h24.14c7,0,10.59,3.59,10.59,9.42s-3.59,9.33-10.59,9.33h-24.14v45.05c0,9.78,3.86,14.09,12.74,14.09,4.76,0,8.08-1.08,10.77-1.98,2.15-.72,3.95-1.52,6.28-1.52,4.58,0,8.44,3.77,8.44,9.06s-3.14,8.08-7.99,9.96c-5.21,1.97-11.76,3.59-18.76,3.59-19.03,0-31.86-10.86-31.86-31.23v-76.47c0-6.82,3.95-10.77,10.14-10.77s10.23,3.95,10.23,10.77Z"/>%0A <path class="st2" d="M559.96,233.95v-55.73c0-19.3,11.76-31.32,30.69-31.32,6.01,0,11.22.72,15.17,1.89,5.83,1.61,9.87,4.67,9.87,10.32,0,6.28-4.22,9.87-8.44,9.87-1.97,0-3.41-.36-4.85-.72-3.05-.81-5.92-1.26-9.69-1.26-8.44,0-12.39,4.04-12.39,12.39v54.57c0,6.82-3.95,10.86-10.14,10.86s-10.23-4.04-10.23-10.86Z"/>%0A <path class="st2" d="M624.04,214.83c0-15.08,11.76-28.9,36.08-28.9,7.81,0,14.72.99,22.89,3.14v-7.45c0-10.86-5.74-16.25-20.28-16.25-6.37,0-12.74,1.62-16.69,3.23-2.69.99-5.21,1.88-7.45,1.88-4.76,0-8.53-3.68-8.62-8.71,0-4.22,2.24-7.54,7.81-9.69,6.19-2.6,15.8-5.21,26.48-5.21,24.5,0,38.41,11.04,38.41,35.27v46.13c0,3.68-.99,5.56-3.77,7.45-5.65,3.86-19.57,9.87-37.87,9.87-23.78,0-36.98-13.37-36.98-30.78ZM662.73,228.84c7.27,0,14.81-2.06,20.28-4.94v-20.19c-7.45-2.24-13.55-3.23-20.37-3.23-12.83,0-19.21,6.28-19.21,14.36,0,8.89,7.54,14,19.3,14Z"/>%0A <path class="st2" d="M724.12,235.12c0-.81.09-2.06.18-2.78l13.73-96.57c2.15-15.17,9.51-20.01,20.1-20.01,9.51,0,16.78,3.95,19.66,19.12l18.4,85.71c.45,1.62.72,2.33,1.98,2.33,1.35,0,1.7-.72,2.06-2.42l18.31-85.62c2.87-15.17,10.05-19.12,19.57-19.12,10.68,0,17.95,4.85,20.01,20.1l13.73,96.03c.18,1.44.27,2.24.27,3.32,0,5.84-3.95,9.6-9.69,9.6-6.55,0-10.14-3.5-10.86-10.05l-12.12-94.86c-.27-1.89-.72-2.51-1.88-2.51-.99,0-1.53.45-1.88,2.15l-19.57,88.22c-2.42,11.58-8.53,17.05-18.13,17.05-10.23,0-15.71-5.57-18.22-17.14l-19.48-88.04c-.45-1.62-.99-2.24-1.79-2.24-1.17,0-1.71.72-1.97,2.6l-11.85,94.78c-.81,6.64-4.31,10.05-10.41,10.05s-10.14-3.59-10.14-9.69Z"/>%0A <path class="st2" d="M891.08,208.91c-.63-6.73-.63-17.68-.09-23.96,2.06-22.17,18.04-37.87,42.18-37.87s39.67,16.06,39.67,39.67v5.3c0,9.87-1.97,11.31-10.86,11.31h-51.88c0,1.26,0,2.6.09,3.86.72,12.03,9.96,20.01,24.32,20.01,7.9,0,13.91-1.71,18.85-3.68,2.96-1.08,4.85-2.06,7.45-2.06,4.85,0,8.44,3.14,8.44,8.44.09,5.12-3.77,8.08-7.54,9.78-6.91,3.32-16.78,5.92-27.64,5.92-24.5,0-41.01-15.08-42.99-36.71ZM954,188.81c1.26-15.44-7.81-24.32-21.45-24.32s-21.54,8.98-22.35,22.08c0,.72-.09,1.53-.09,2.24h43.89Z"/>%0A <path class="st2" d="M1074.18,125.17v102.85c0,3.95-1.08,5.92-3.86,7.81-5.83,3.86-20.1,9.78-37.16,9.78-23.87,0-39.22-14.81-41.19-36.17-.72-7.27-.72-19.21,0-26.39,1.97-21.36,17.32-36.17,39.4-36.17,8.17,0,16.78,2.06,22.44,4.85v-26.57c0-6.82,3.95-10.86,10.23-10.86s10.14,4.04,10.14,10.86ZM1033.97,225.87c6.91,0,15.53-2.06,19.83-5.11v-49c-4.31-3.05-12.93-5.12-19.83-5.12-13.37,0-20.73,7.99-21.81,19.75-.54,6.55-.45,13.82,0,19.74,1.08,11.76,8.44,19.75,21.81,19.75Z"/>%0A </g>%0A <g>%0A <path class="st1" d="M101.42,217.17c0-.64.07-1.63.14-2.2l10.87-76.46c1.71-12.01,7.53-15.85,15.92-15.85,7.53,0,13.29,3.13,15.56,15.14l14.57,67.86c.36,1.28.57,1.85,1.56,1.85,1.07,0,1.35-.57,1.63-1.92l14.5-67.79c2.27-12.01,7.96-15.14,15.49-15.14,8.46,0,14.21,3.84,15.85,15.92l10.87,76.04c.14,1.14.21,1.78.21,2.63,0,4.62-3.13,7.6-7.67,7.6-5.19,0-8.03-2.77-8.6-7.96l-9.59-75.11c-.21-1.49-.57-1.99-1.49-1.99-.78,0-1.21.36-1.49,1.71l-15.49,69.85c-1.92,9.17-6.75,13.5-14.36,13.5-8.1,0-12.44-4.41-14.43-13.57l-15.42-69.71c-.36-1.28-.78-1.78-1.42-1.78-.92,0-1.35.57-1.56,2.06l-9.38,75.04c-.64,5.26-3.41,7.96-8.24,7.96s-8.03-2.84-8.03-7.67Z"/>%0A <path class="st1" d="M90.62,131.29v84.42c0,5.54-3.2,8.88-8.24,8.88s-8.31-3.34-8.31-8.88v-84.42c0-5.54,3.27-8.88,8.31-8.88s8.24,3.34,8.24,8.88Z"/>%0A </g>%0A <g>%0A <path class="st0" d="M74.36,202.14c19.92.79,54.3-4.62,92.4-15.33,58-16.32,102.67-38.77,99.76-50.15-2-7.85-26.05-8.39-59.77-2.65,23.98-2.82,37.51-1.37,39.11,4.9,2.82,11.03-37.79,32.76-93.95,48.56-1.26.35-2.51.7-3.76,1.04,0,0,0,0-.01,0-13.29,3.95-50.37,13.62-73.78,13.62Z"/>%0A <path class="st0" d="M191.55,191.02c-13.03,4.75-27.19,9.32-42.09,13.5-70.38,19.79-130.56,23.59-134.41,8.48-2.65-10.4,20.1-26.01,58.76-41.85-26.73,12.73-38.09,24.13-35.96,32.45,3.73,14.63,59.37,10.95,127.5-8.22,36.59-10.29,68.58-22.95,89.79-34.73-9.63,6.73-23.48,14.01-40.32,21.2-4.91,2.44-18.07,7.34-23.28,9.16Z"/>%0A </g>%0A </g>%0A</svg>%0A)