{"id":31211,"date":"2025-07-22T14:19:11","date_gmt":"2025-07-22T11:19:11","guid":{"rendered":"https:\/\/www.utkuerdemozer.com\/chirurgia-mpfl\/"},"modified":"2026-04-01T02:20:56","modified_gmt":"2026-03-31T23:20:56","slug":"chirurgia-mpfl","status":"publish","type":"post","link":"https:\/\/www.utkuerdemozer.com\/ro\/chirurgia-mpfl\/","title":{"rendered":"Chirurgia MPFL"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Luxa\u021bia recurent\u0103 a rotulei (patela) nu numai c\u0103 provoac\u0103 durere, dar duce \u0219i la o senza\u021bie de instabilitate, mi\u0219care restric\u021bionat\u0103 \u0219i, \u00een timp, la <strong><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/leziuni-ale-cartilajului-la-genunchi-si-optiuni-chirurgicale\/\">leziuni permanente ale cartilajului<\/a><\/strong> \u00een articula\u021bia genunchiului. Aceast\u0103 afec\u021biune poate reduce semnificativ calitatea vie\u021bii \u0219i poate face participarea la sport aproape imposibil\u0103. Dac\u0103 tratamentul adecvat nu este planificat \u00een stadiile incipiente, fiecare nou\u0103 luxa\u021bie poate provoca leziuni suplimentare cartilajului articular.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Reconstruc\u021bia LPFM (ligamentul patelofemural medial)<\/strong> este tratamentul chirurgical efectuat \u00een astfel de cazuri. Chirurgia LPFM nu este, \u00een general, efectuat\u0103 singur\u0103; este adesea combinat\u0103 cu <strong>osteotomia tuberozit\u0103\u021bii tibiale<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Ce este LPFM?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>LPFM (Ligamentul Patelofemural Medial)<\/strong> este un ligament important care conecteaz\u0103 rotula de osul coapsei (femur). Acesta previne alunecarea lateral\u0103 a rotulei. \u00cen majoritatea cazurilor, LPFM se rupe atunci c\u00e2nd <a href=\"https:\/\/www.utkuerdemozer.com\/ro\/luxatia-rotulei\/\">rotula se luxeaz\u0103<\/a> pentru prima dat\u0103. Odat\u0103 rupt, rotula devine mai predispus\u0103 la luxa\u021bii recurente. \u00cen astfel de cazuri, ligamentul trebuie <strong>reconstruit<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Cauzele luxa\u021biei patelare<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Rotula se mi\u0219c\u0103 \u00een sus \u0219i \u00een jos \u00eentr-un \u0219an\u021b special (trohlee) de pe osul coapsei. Cu toate acestea, la unele persoane, acest \u0219an\u021b poate fi superficial sau rotula poate fi pozi\u021bionat\u0103 anormal. \u00cen plus, atunci c\u00e2nd LPFM este rupt, rotula poate devia spre exterior \u0219i se poate luxa.<br>Cauzele comune ale luxa\u021biei patelare includ:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>C\u0103deri sau leziuni prin r\u0103sucire \u00een timpul sportului<\/li>\n\n\n\n<li>Predispozi\u021bie genetic\u0103 (ligamente laxe)<\/li>\n\n\n\n<li>Rotul\u0103 \u00eenalt\u0103 (patella alta)<\/li>\n\n\n\n<li>Displazie trohlear\u0103 (un \u0219an\u021b femural plat)<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Simptome<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ruptura LPFM \u0219i instabilitatea patelar\u0103 pot provoca urm\u0103toarele simptome:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Senza\u021bia de deplasare lateral\u0103 a rotulei<\/li>\n\n\n\n<li>Instabilitate a genunchiului sau senza\u021bia c\u0103 cedeaz\u0103<\/li>\n\n\n\n<li>Dificultate la cobor\u00e2rea sc\u0103rilor sau la practicarea sportului<\/li>\n\n\n\n<li><a href=\"https:\/\/www.utkuerdemozer.com\/ro\/durere-anterioara-de-genunchi\/\">Durere anterioar\u0103 de genunchi<\/a><\/li>\n\n\n\n<li>Luxa\u021bii recurente ale rotulei<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Cine este un candidat pentru reconstruc\u021bia LPFM?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Nu orice luxa\u021bie patelar\u0103 necesit\u0103 interven\u021bie chirurgical\u0103. Cu toate acestea, interven\u021bia chirurgical\u0103 devine necesar\u0103 \u00een anumite cazuri. Reconstruc\u021bia LPFM este, \u00een general, recomandat\u0103 pacien\u021bilor care:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Au suferit mai mult de o luxa\u021bie patelar\u0103<\/li>\n\n\n\n<li>Au o ruptur\u0103 de LPFM confirmat\u0103 prin RMN<\/li>\n\n\n\n<li>Nu pot ob\u021bine stabilitate prin fizioterapie \u0219i \u00eent\u0103rirea muscular\u0103<\/li>\n\n\n\n<li>Sunt tineri, activi \u0219i sportivi<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Evaluare preoperatorie<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Un diagnostic corect \u0219i un plan de tratament necesit\u0103 at\u00e2t examinare clinic\u0103, c\u00e2t \u0219i studii imagistice:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Radiografie:<\/strong> Evalueaz\u0103 pozi\u021bia rotulei \u0219i posibilele fracturi<\/li>\n\n\n\n<li><strong>RMN:<\/strong> Arat\u0103 rupturile LPFM, leziunile cartilajului \u0219i starea ligamentelor<\/li>\n\n\n\n<li><strong>Tomografie computerizat\u0103 (CT):<\/strong> Evalueaz\u0103 alinierea trohlee-patel\u0103 \u0219i m\u0103soar\u0103 distan\u021ba TT\u2013TG<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Pe baza acestor evalu\u0103ri, se decide dac\u0103 <strong>reconstruc\u021bia LPFM este suficient\u0103 singur\u0103<\/strong> sau dac\u0103 sunt necesare proceduri corective suplimentare.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Cum se realizeaz\u0103 reconstruc\u021bia LPFM?<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">LPFM este de obicei reconstruit folosind o gref\u0103 prelevat\u0103 din <a href=\"https:\/\/www.utkuerdemozer.com\/ro\/tratamentul-rupturii-musculare-a-ischiogambierilor\/\">tendoanele ischiogambiere<\/a> (de obicei tendonul gracilis). Etapele chirurgicale includ:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Prelevarea grefei:<\/strong> Se preleveaz\u0103 tendonul gracilis sau semitendinos.<\/li>\n\n\n\n<li><strong>Tuneluri patelare:<\/strong> Se foreaz\u0103 tuneluri mici pe partea interioar\u0103 a rotulei.<\/li>\n\n\n\n<li><strong>Fixarea patelar\u0103:<\/strong> Grefa este fixat\u0103 la rotul\u0103 cu \u0219uruburi speciale sau ancore de sutur\u0103.<\/li>\n\n\n\n<li><strong>Fixarea femural\u0103:<\/strong> Cel\u0103lalt cap\u0103t al grefei este fixat la punctul anatomic corect de pe femur.<\/li>\n\n\n\n<li><strong>Ajustarea tensiunii:<\/strong> Grefa este str\u00e2ns\u0103 pentru a men\u021bine rotula aliniat\u0103 pe linia median\u0103.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Interven\u021bia chirurgical\u0103 nu este efectuat\u0103 \u00een \u00eentregime artroscopic, dar este de obicei realizat\u0103 prin incizii mici, urm\u00e2nd o abordare anatomic\u0103 \u0219i fiabil\u0103.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Recuperare postoperatorie<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Un protocol de fizioterapie personalizat este esen\u021bial dup\u0103 interven\u021bia chirurgical\u0103:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>S\u0103pt\u0103m\u00e2nile 0\u20133:<\/strong> Protec\u021bie cu ortez\u0103 de genunchi, ajutoare pentru mers la nevoie<\/li>\n\n\n\n<li><strong>S\u0103pt\u0103m\u00e2nile 3\u20136:<\/strong> Cre\u0219tere gradual\u0103 a amplitudinii de mi\u0219care, \u00eent\u0103rire muscular\u0103 u\u0219oar\u0103<\/li>\n\n\n\n<li><strong>S\u0103pt\u0103m\u00e2nile 6\u201312:<\/strong> Antrenament de for\u021b\u0103, exerci\u021bii de echilibru \u0219i coordonare<\/li>\n\n\n\n<li><strong>Dup\u0103 3 luni:<\/strong> Alergare u\u0219oar\u0103 \u0219i exerci\u021bii de revenire la sport<\/li>\n\n\n\n<li><strong>Luni 4\u20136:<\/strong> Revenirea complet\u0103 la sport (pe baza evalu\u0103rii individuale)<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>\u00centreb\u0103ri frecvente despre chirurgia LPFM<\/strong><\/h2>\n\n\n<div id=\"rank-math-faq\" class=\"rank-math-block\">\n<div class=\"rank-math-list \">\n<div id=\"faq-question-1771507431492\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Se va luxa din nou rotula dup\u0103 chirurgia LPFM?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Cu o tehnic\u0103 chirurgical\u0103 \u0219i o reabilitare adecvate, riscul de recuren\u021b\u0103 este foarte sc\u0103zut.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-1771507436208\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Exist\u0103 mult\u0103 durere dup\u0103 opera\u021bie?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Durerea este, \u00een general, u\u0219oar\u0103 \u0219i de scurt\u0103 durat\u0103, controlat\u0103 prin protocoale de gestionare a durerii.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-1771507436864\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">C\u00e2nd se pot relua activit\u0103\u021bile sportive?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>\u00cen func\u021bie de pacient \u0219i de tipul de sport, revenirea u\u0219oar\u0103 \u00eencepe \u00een jurul lunii a 3-a, cu revenirea complet\u0103 de obicei \u00eentre 4\u20136 luni.<\/p>\n\n<\/div>\n<\/div>\n<div id=\"faq-question-1771507437824\" class=\"rank-math-list-item\">\n<h3 class=\"rank-math-question \">Este suficient\u0103 doar reconstruc\u021bia LPFM?<\/h3>\n<div class=\"rank-math-answer \">\n\n<p>Fiecare pacient este unic. Unele cazuri necesit\u0103, de asemenea,\u00a0<a href=\"https:\/\/www.utkuerdemozer.com\/ro\/ce-este-transplantul-de-cartilaj-implantarea-autologa-de-condrocite\/\">repararea cartilajului<\/a>, realinierea tuberozit\u0103\u021bii tibiale sau trohleoplastie.<\/p>\n\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\"><strong>Concluzie<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Reconstruc\u021bia LPFM este o interven\u021bie chirurgical\u0103 anatomic\u0103 de mare succes pentru luxa\u021biile patelare recurente. Aceasta restabile\u0219te stabilitatea genunchiului, \u00een special la persoanele tinere \u0219i active, \u00eembun\u0103t\u0103\u021bind semnificativ calitatea vie\u021bii. Diagnosticul precoce, planificarea chirurgical\u0103 precis\u0103 \u0219i reabilitarea individualizat\u0103 asigur\u0103 cele mai bune rezultate.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Luxa\u021bia recurent\u0103 a rotulei (patela) nu numai c\u0103 provoac\u0103 durere, dar duce \u0219i la o [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":23546,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,19],"tags":[],"class_list":["post-31211","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-diz-cerrahisi","category-spor-cerrahisi-ve-artroskopi"],"_links":{"self":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/31211","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/comments?post=31211"}],"version-history":[{"count":2,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/31211\/revisions"}],"predecessor-version":[{"id":32976,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/posts\/31211\/revisions\/32976"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/media\/23546"}],"wp:attachment":[{"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/media?parent=31211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/categories?post=31211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.utkuerdemozer.com\/ro\/wp-json\/wp\/v2\/tags?post=31211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}