{"id":3203,"date":"2025-02-18T08:02:53","date_gmt":"2025-02-18T07:02:53","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=3203"},"modified":"2025-02-18T09:44:05","modified_gmt":"2025-02-18T08:44:05","slug":"luxation-et-instabilite-patellaire-2","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=3203","title":{"rendered":"Luxation et instabilit\u00e9 patellaire"},"content":{"rendered":"\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p><strong>D\u00e9finition<\/strong><br>L&rsquo;instabilit\u00e9 patellaire d\u00e9signe un d\u00e9placement anormal de la patella qui sort de sa cavit\u00e9 entra\u00eenant une luxation.<\/p>\n\n\n\n<p><strong>Physiopathologie<\/strong><br>&#8211; Souvent cons\u00e9cutif \u00e0 un traumatisme du genou<br>&#8211; Pathologie du syst\u00e8me conjonctif (syndrome d&rsquo;Ehlers-Danlos) : la laxit\u00e9  pathologique des \u00e9l\u00e9ments p\u00e9ri-articulaire entra\u00eenant la possibilit\u00e9 de subluxation ou de luxation de la patella.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"518\" height=\"171\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-73-png.avif\" alt=\"\" class=\"wp-image-3217\" style=\"width:288px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-73-png.avif 518w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-73-300x99.avif 300w\" sizes=\"auto, (max-width: 518px) 100vw, 518px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"505\" height=\"380\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-68-png.avif\" alt=\"\" class=\"wp-image-3206\" style=\"width:260px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-68-png.avif 505w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-68-300x226.avif 300w\" sizes=\"auto, (max-width: 505px) 100vw, 505px\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<p><strong>Epid\u00e9miologie<\/strong><br>&#8211; Incidence de l&rsquo;instabilit\u00e9 : 5,8 pour 100 000 habitants<\/p>\n\n\n\n<p><strong>Facteurs de risque<\/strong><br>&#8211; Instabilit\u00e9 : au moins une luxation, souvent en lat\u00e9rale<br>&#8211; Patella alta \/ dysplasie trochl\u00e9aire (trochl\u00e9e plate)<br>&#8211; ATCD de chirurgie de genou (ligament crois\u00e9)<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"236\" height=\"198\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-69-png.avif\" alt=\"\" class=\"wp-image-3210\" style=\"width:181px;height:auto\"\/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"336\" height=\"188\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-70-png.avif\" alt=\"\" class=\"wp-image-3212\" style=\"width:178px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-70-png.avif 336w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-70-300x168.avif 300w\" sizes=\"auto, (max-width: 336px) 100vw, 336px\" \/><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Diagnostic clinique<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>&#8211; Douleur \u00e0 la palpation lat\u00e9rale ou m\u00e9diale de la patella<br>&#8211; Course patellaire lors de mouvements fonctionnels : mont\u00e9e d&rsquo;escalier, squat<br>&#8211; Hypermobilit\u00e9 de la patella, surtout lat\u00e9ralement<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>&#8211; <a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-png.avif\"><strong>Score de Beighton<\/strong><\/a> pour d\u00e9celer une hyperlaxit\u00e9 ligamentaire globale. Un score compris entre 4 et 9 indique une laxit\u00e9 ligamentaire.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-png.avif\"><img loading=\"lazy\" decoding=\"async\" width=\"1015\" height=\"320\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-png.avif\" alt=\"\" class=\"wp-image-3215\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-png.avif 1015w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-300x95.avif 300w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-71-768x242.avif 768w\" sizes=\"auto, (max-width: 1015px) 100vw, 1015px\" \/><\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>&#8211; <strong>Imagerie <\/strong>pour les facteurs de risque<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-72-png.avif\"><img loading=\"lazy\" decoding=\"async\" width=\"593\" height=\"320\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-72-png.avif\" alt=\"\" class=\"wp-image-3216\" style=\"width:248px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-72-png.avif 593w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-72-300x162.avif 300w\" sizes=\"auto, (max-width: 593px) 100vw, 593px\" \/><\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p>&#8211; <strong>Test d&rsquo;appr\u00e9hension de Smilie<\/strong><br>Genou fl\u00e9chi, la patella est pouss\u00e9e lat\u00e9ralement en m\u00eame temps que le MK mobilise le genou en extension. Le test est positif en cas d&rsquo;appr\u00e9hension du patient.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Test d&#039;appr\u00e9hension de Smilie [ instabilit\u00e9s &amp; luxations patellaires ]\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/FyUw3uH7n74?start=1&#038;feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Patient type<\/strong><br>&#8211; Historique de trauma<br>&#8211; Pathologie du syst\u00e8me conjonctif<br>&#8211; Palpation lat\u00e9rale ou m\u00e9diale douloureuse<br>&#8211; Sensation d&rsquo;instabilit\u00e9 subjective<br>&#8211; Test d&rsquo;appr\u00e9hension positif<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Th\u00e9rapeutiques<\/strong><\/p>\n\n\n\n<p>Traitement conservateur<br>&#8211; Stabilit\u00e9 active pour compenser la perte de stabilit\u00e9 passive<br>&#8211; Proprioception et contr\u00f4le moteur pour stabiliser la patella<\/p>\n\n\n\n<p><strong>Traitement chirurgical<\/strong><br>&#8211; Reconstruction des ligaments m\u00e9diaux arrach\u00e9s (MPFL)<br>&#8211; <a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-74-png.avif\">Tibial tubercule distalisation <\/a>pour la patella alta<br>&#8211; Trochl\u00e9oplastie pour dysplasie trochl\u00e9aire majeure<br>&#8211; Kin\u00e9 post-chirurgi<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Vid\u00e9os<\/strong><\/p>\n\n\n\n<p><strong><em>Instabilit\u00e9 f\u00e9moro-Patellaire par le Dr Tourtoulou<\/em><\/strong><br>Par OLS &#8211; OrthoLiveStream<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>&#8211; Incidence et m\u00e9canisme l\u00e9sionnel<br>&#8211; Instabilit\u00e9 f\u00e9moro-patellaire aig\u00fc : dislocation lat\u00e9rale, douleur de genou, flessum, r\u00e9duction par l&rsquo;extension<br>&#8211; Instabilit\u00e9 chronique d\u00e9cel\u00e9e par 4 tests : patellar tilt test, patellar glide test, patellar apprehension sign, patellar J-sign (subluxation par l&rsquo;extension)<br>&#8211; Imagerie pour d\u00e9celer les facteurs de risque, notamment la dysplasie trochl\u00e9aire et la patella alta<br>&#8211; La classification de Dejour pour la dysplasie (A, B, C, D) : signe du croisement (effacement progressif de la gorge trochl\u00e9enne), le signe du double contour (asym\u00e9trie des berges de la trochl\u00e9e). <br>&#8211; Questions avant la PEC : premier \u00e9pisode ? Fracture ost\u00e9o-chondrale associ\u00e9e ? Facteurs de r\u00e9cidive ?<br>&#8211; Algorithme de traitement : traitement orthop\u00e9dique pour un premier \u00e9pisode, chirurgie d\u00e8s la premi\u00e8re r\u00e9cidive.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Instabilit\u00e9 f\u00e9moro-Patellaire par le Dr Tourtoulou\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/VyaLWhH_QdE?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong><em>R\u00e9\u00e9ducation de la Luxation Rotule : Genoux Forts en 3 Exercices<\/em><\/strong><br>Par <a href=\"https:\/\/www.youtube.com\/@orthoinfo2384\">Ortho Info<\/a><\/p>\n\n\n\n<p>Exercices propos\u00e9s :<br>&#8211; Contraction isom\u00e9trique du vaste m\u00e9dial<br>&#8211; Extension du genou contre r\u00e9sistance en position assise<br>&#8211; Flexion de genou contre r\u00e9sistance en d\u00e9cubitus ventral<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"R\u00e9\u00e9ducation de la Luxation Rotule : Genoux Forts en 3 Exercices | Orthoinfo.ca\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/fAfmE01lVls?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong><em>Am\u00e9lior\u00e9 l&rsquo;instabilit\u00e9 du genou<\/em><\/strong><br>Par Centre Moveo Clinic<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Am\u00e9lior\u00e9 l&#039;instabilit\u00e9 du genou\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/kspa1laTbqs?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>D\u00e9finitionL&rsquo;instabilit\u00e9 patellaire d\u00e9signe un d\u00e9placement anormal de la patella qui sort de sa cavit\u00e9 entra\u00eenant une luxation. Physiopathologie&#8211; Souvent cons\u00e9cutif \u00e0 un traumatisme du genou&#8211; Pathologie du syst\u00e8me conjonctif (syndrome d&rsquo;Ehlers-Danlos) : la laxit\u00e9 pathologique&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=3203\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Luxation et instabilit\u00e9 patellaire\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[357],"tags":[],"class_list":["post-3203","post","type-post","status-publish","format-standard","hentry","category-pathologie-genou"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/3203","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3203"}],"version-history":[{"count":10,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/3203\/revisions"}],"predecessor-version":[{"id":3229,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/3203\/revisions\/3229"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3203"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3203"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}