Magnussen Robert A, Verlage Megan, Stock Elizabeth, Zurek Lauren, Flanigan David C, Tompkins Marc, Agel Julie, Arendt Elizabeth A
Department of Orthopaedics, Sports Health and Performance Institute, The Ohio State University, Columbus, OH, 43214, USA.
Sports Health and Performance Institute, The Ohio State University, Columbus, OH, USA.
Knee Surg Sports Traumatol Arthrosc. 2017 Aug;25(8):2352-2356. doi: 10.1007/s00167-015-3716-3. Epub 2015 Jul 28.
While a significant research has gone into identifying patients at highest risk of recurrence following primary patellar dislocation, there has been little work exploring the outcomes of patients who do not have a recurrent patellar dislocation. We hypothesize that patients without recurrent dislocation episodes will exhibit significantly higher KOOSs than those who suffer recurrent dislocations, but lower scores than published age-matched normative data.
A retrospective review of patients with nonoperatively treated primary lateral patellar dislocations was carried out, and patients were contacted at a mean of 3.4 years (range 1.3-5.5 years) post-injury. Information regarding subsequent treatment and recurrent dislocations along with patient-reported outcome scores and activity level was collected.
One hundred and eleven patients (29.8 %) of 373 eligible patients agreed to study participation, seven of whom were excluded because they underwent subsequent patellar stabilization surgery on the index knee. Seventy-six patients (73.1 %) reported no further dislocation events, and the mean KOOS subscales at follow-up were: symptoms-80.2 ± 18.8, pain-81.8 ± 16.2, ADL-88.7 ± 15.9, sport/recreation-72.1 ± 24.4, and QOL-63.9 ± 23.8 at a mean follow-up of 3.3 years (range 1.3-5.5 years). No significant differences in any of the KOOS subscales were noted between these patients and the group that reported recurrent patellar dislocations. Only 26.4 % of the patients without further dislocations reported they were able to return to desired sport activities without limitations following their dislocation.
Patients who do not report recurrent patellar dislocations following nonoperative treatment of primary patellar dislocations are in many cases limited by this injury 3 years following the initial dislocation event.
Retrospective cohort study, Level III.
虽然在确定初次髌骨脱位后复发风险最高的患者方面已经进行了大量研究，但对于没有复发性髌骨脱位的患者的预后情况，却鲜有研究。我们假设，没有复发性脱位发作的患者的膝关节损伤与骨关节炎疗效评分（KOOS）显著高于那些有复发性脱位的患者，但低于已公布的年龄匹配的标准数据。
对非手术治疗的初次外侧髌骨脱位患者进行回顾性研究，并在受伤后平均3.4年（范围1.3 - 5.5年）联系患者。收集有关后续治疗和复发性脱位的信息，以及患者报告的预后评分和活动水平。
373名符合条件的患者中有111名（29.8%）同意参与研究，其中7名因对患侧膝关节进行了后续的髌骨稳定手术而被排除。76名患者（73.1%）报告没有进一步的脱位事件，随访时KOOS各分量表的平均值为：症状 - 80.2±18.8，疼痛 - 81.8±16.2，日常生活活动能力（ADL） - 88.7±15.9，运动/娱乐 - 72.1±24.4，生活质量（QOL） - 63.9±23.8，平均随访3.3年（范围1.3 - 5.5年）。在这些患者与报告有复发性髌骨脱位的组之间，未发现KOOS各分量表有任何显著差异。在没有进一步脱位的患者中，只有26.4%的患者报告他们在脱位后能够不受限制地恢复到期望的体育活动。
初次髌骨脱位非手术治疗后未报告复发性髌骨脱位的患者，在初次脱位事件3年后，在很多情况下仍受此损伤的限制。
回顾性队列研究，三级。
