Howells N R, Eldridge J D
Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK.
J Bone Joint Surg Br. 2012 Dec;94(12):1655-9. doi: 10.1302/0301-620X.94B12.29562.
Hypermobility is an acknowledged risk factor for patellar instability. In this case control study the influence of hypermobility on clinical outcome following medial patellofemoral ligament (MPFL) reconstruction for patellar instability was studied. A total of 25 patients with hypermobility as determined by the Beighton criteria were assessed and compared with a control group of 50 patients who were matched for age, gender, indication for surgery and degree of trochlear dysplasia. The patients with hypermobility had a Beighton Score of ≥ 6; the control patients had a score of < 4. All patients underwent MPFL reconstruction performed using semitendinosus autograft and a standardised arthroscopically controlled technique. The mean age of the patients was 25 years (17 to 49) and the mean follow-up was 15 months (6 to 30). Patients with hypermobility had a significant improvement in function following surgery, with reasonable rates of satisfaction, perceived improvement, willingness to repeat and likelihood of recommendation. Functional improvements were significantly less than in control patients (p < 0.01). Joint hypermobility is not a contraindication to MPFL reconstruction although caution is recommended in managing the expectations of patients with hypermobility before consideration of surgery.
关节活动过度是公认的髌骨不稳定风险因素。在这项病例对照研究中，研究了关节活动过度对髌骨不稳定患者行内侧髌股韧带（MPFL）重建术后临床结果的影响。根据Beighton标准确定，共有25例关节活动过度患者接受评估，并与50例年龄、性别、手术指征和滑车发育不良程度相匹配的对照组患者进行比较。关节活动过度患者的Beighton评分为≥6分；对照组患者评分为<4分。所有患者均采用半腱肌自体移植物和标准化关节镜控制技术进行MPFL重建。患者的平均年龄为25岁（17至49岁），平均随访时间为15个月（6至30个月）。关节活动过度患者术后功能有显著改善，满意度、自我感觉改善、愿意再次手术和推荐可能性的比率合理。功能改善明显低于对照组患者（p<0.01）。关节活动过度并非MPFL重建的禁忌证，不过在考虑手术前，建议谨慎对待关节活动过度患者的预期。
