Ambrožič Bogdan, Novak Samo
a Department for Arthroscopy and Sports Medicine , Valdoltra Orthopaedic Hospital , Jadranska cesta 31, SI-6280 Ankaran , Slovenia.
b Orthopaedic Surgery Resident , Valdoltra Orthopaedic Hospital , Jadranska cesta 31, SI-6280 Ankaran , Slovenia.
Phys Sportsmed. 2016;44(2):133-40. doi: 10.1080/00913847.2016.1148561. Epub 2016 Feb 24.
The aim of this study was to demonstrate postoperative outcomes and return to regular physical and sports activities at average of 6 years after patellar stabilization with medial patellofemoral ligament (MPFL) reconstruction.
Between November 2006 and January 2010, 31 isolated MPFL reconstructions in 29 patients with recurrent patellar dislocation were performed. Radiographs and magnetic resonance imaging were evaluated preoperatively. Knee function was assessed pre- and postoperative using Kujala score and the patient satisfaction, according to the International Knee Documentation Committee (IKDC) score. Tegner activity score was used for the evaluation of sports activity level.
The average follow-up was 6.4±1.2 years. All measured scores increased significantly at follow-up. The average Kujala score increased from 75±10 to 95±10, patient satisfaction according to IKDC score from 6.1±1.4 to 8.7±1.4 and Tegner activity score from 4.4±1.6 to 5.7±1.3. The Tegner activity score after surgery was significantly lower than the score before the patellar dislocation (6.7±1.3). There were no significant differences in Kujala postoperative score between women's and men's group (P=0.25). There was no significant correlation between body mass index and Kujala score postoperatively (P=0.11) and between age at surgery and Kujala scores postoperatively (P=0.56). Patients who were active in sports preoperatively had resumed sports activities in 88.5% after surgery, 69.6% of them returned to the same levels and 30.4% return to the lower levels.
Patellar stabilization with MPFL reconstruction is a safe and effective treatment method for all patients with patellofemoral instability and allows most patients to return to regular physical and sports activities after surgical intervention. Although sports activity level increased significantly after surgery, the same level of sports activity before the patellar dislocation has not been achieved.
本研究旨在展示髌股内侧韧带(MPFL)重建髌骨稳定术后平均6年的术后结果以及恢复正常体育活动的情况。
2006年11月至2010年1月期间,对29例复发性髌骨脱位患者进行了31例单纯MPFL重建手术。术前对X线片和磁共振成像进行评估。术前和术后使用库贾拉评分评估膝关节功能,并根据国际膝关节文献委员会(IKDC)评分评估患者满意度。采用特格纳活动评分评估体育活动水平。
平均随访时间为6.4±1.2年。随访时所有测量评分均显著提高。库贾拉评分平均从75±10提高到95±10,根据IKDC评分的患者满意度从6.1±1.4提高到8.7±1.4,特格纳活动评分从4.4±1.6提高到5.7±1.3。术后特格纳活动评分显著低于髌骨脱位前的评分(6.7±1.3)。女性组和男性组术后库贾拉评分无显著差异(P=0.25)。体重指数与术后库贾拉评分之间(P=0.11)以及手术年龄与术后库贾拉评分之间(P=0.56)均无显著相关性。术前积极参加体育活动的患者术后88.5%恢复了体育活动,其中69.6%恢复到相同水平,30.4%恢复到较低水平。
MPFL重建髌骨稳定术对于所有髌股关节不稳定患者是一种安全有效的治疗方法,并且能使大多数患者在手术干预后恢复正常体育活动。尽管术后体育活动水平显著提高,但尚未达到髌骨脱位前的相同体育活动水平。