Oslo University Hospital and University of Oslo, Oslo, Norway.
OSTRC, The Norwegian School of Sports Sciences, Oslo, Norway.
Knee Surg Sports Traumatol Arthrosc. 2017 Dec;25(12):3914-3922. doi: 10.1007/s00167-017-4443-8. Epub 2017 Mar 9.
Long-term outcomes and the prevalence of osteoarthritis after surgical treatment of knee dislocations are lacking in the literature. The purpose of this study was to investigate the prevalence of knee osteoarthritis and knee function at a minimum of 10 years after knee dislocation surgery.
Sixty-five patients surgically treated for knee dislocations at a single level I trauma center between May 1996 and December 2004 were evaluated at a minimum of 10 years. Patients were evaluated with radiographs for knee osteoarthritis using the Kellgren-Lawrence (KL) grading system, Tegner activity score, Lysholm score, IKDC-2000, KOOS, subjective stability on physical examination, KT-1000 arthrometer, and single-leg hop tests. Osteoarthritis was defined as KL grades 2 or greater.
The median follow-up time was 12.7 years (range 10.0-18.8 years), and the median age was 46.9 years (range 26.8-76.1 years). Radiographic osteoarthritis was present in 42% (23, 14, and 5% in KL grades II, III, and IV, respectively) of the patients in the operated knee compared to 6% in the uninjured knee. Knee function was generally improved with a median Tegner activity score of 4 (range 1-8), an average Lysholm score of 84 ± 17, and an average IKDC-2000 score of 73 ± 19.
Twenty-seven patients (42%) developed OA 10 years after surgical treatment of knee dislocations. Patients reported improved knee function and minimal-to-moderate pain. Age at surgery was a predictor of development of OA, with more patients >30 years at the time of surgery developing OA. Meniscal and cartilage injuries at time of surgery were not associated with development of OA. Patients being treated for knee dislocation should be counselled about the increased long-term risk of post-traumatic OA.
III.
手术治疗膝关节脱位后的长期结果和骨关节炎的患病率在文献中缺乏。本研究的目的是调查膝关节脱位手术后至少 10 年时膝关节骨关节炎的患病率和膝关节功能。
1996 年 5 月至 2004 年 12 月，在一家一级创伤中心对 65 例膝关节脱位患者进行手术治疗，并在至少 10 年后进行评估。对患者进行膝关节放射照相，使用 Kellgren-Lawrence (KL) 分级系统、Tegner 活动评分、Lysholm 评分、IKDC-2000、KOOS、体格检查的主观稳定性、KT-1000 关节测量仪和单腿跳跃测试来评估膝关节骨关节炎。骨关节炎定义为 KL 分级 2 级或更高。
中位随访时间为 12.7 年（范围 10.0-18.8 年），中位年龄为 46.9 岁（范围 26.8-76.1 岁）。与未受伤的膝关节相比，接受手术的膝关节中 42%（23 例，分别为 KL 分级 II、III 和 IV 的 14%和 5%）的患者存在放射照相骨关节炎。膝关节功能普遍改善，Tegner 活动评分中位数为 4（范围 1-8），平均 Lysholm 评分为 84±17，平均 IKDC-2000 评分为 73±19。
27 例（42%）患者在膝关节脱位手术后 10 年出现 OA。患者报告膝关节功能改善，疼痛轻微至中度。手术时的年龄是发生 OA 的预测因素，手术时年龄超过 30 岁的患者发生 OA 的可能性更大。手术时的半月板和软骨损伤与 OA 的发生无关。接受膝关节脱位治疗的患者应告知其发生创伤后 OA 的长期风险增加。
III。
