Vedel J O, Vistrup S, Larsen P, Elsoe R
Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg University, 18-22 Hobrovej, 9000, Aalborg, Denmark.
Eur J Trauma Emerg Surg. 2018 Oct;44(5):707-716. doi: 10.1007/s00068-017-0857-8. Epub 2017 Oct 9.
The primary aim was to investigate the health-related quality of life (HRQOL) in patients treated for a patella fracture. The explorative aim was to report the associations between HRQOL, knee osteoarthritis, muscle strength and gait function.
The study design was a cohort study. Patients who were treated for patella fractures at Aalborg University Hospital, Denmark between January 2006 and December 2009 were identified. Patients between the age of 18 and 80 were included. The main outcome was assessed by the EQ5D-5L questionnaire. Classifications by Sperner and Kellgren/Lawrence were applied to evaluate osteoarthritis. Moreover, functional outcomes were evaluated by: KOOS, muscle strength and gait analysis.
Forty-nine patients were included with a mean follow-up time of 8.5 years. The mean age was 53.9 years. The mean EQ5D-5L index value was 0.741, and was significantly worse compared to a reference population. X-rays taken at the time of diagnosis and the time of follow-up showed progression towards a higher degree of osteoarthritis in the injured knee for both the patellofemoral and tibiofemoral joints. Patients demonstrated significantly lower knee extension strength in the injured leg compared to the non-injured leg (P = 0.011). No significant difference in gait speed and cadence were observed compared to the reference population. Knee osteoarthritis, muscle strength and gait patterns were not associated with HRQOL (R < 0.35).
At 8.5 years following a patella fracture, HRQOL was significantly worse compared to an age-matched reference population.
主要目的是调查髌骨骨折患者的健康相关生活质量（HRQOL）。探索性目的是报告HRQOL、膝关节骨关节炎、肌肉力量和步态功能之间的关联。
本研究设计为队列研究。确定了2006年1月至2009年12月期间在丹麦奥尔堡大学医院接受髌骨骨折治疗的患者。纳入年龄在18至80岁之间的患者。主要结局通过EQ5D-5L问卷进行评估。应用Sperner和Kellgren/Lawrence分类法评估骨关节炎。此外，通过膝关节损伤和骨关节炎疗效评分（KOOS）、肌肉力量和步态分析来评估功能结局。
纳入49例患者，平均随访时间为8.5年。平均年龄为53.9岁。EQ5D-5L指数平均值为0.741，与参照人群相比明显更差。诊断时和随访时拍摄的X线片显示，髌股关节和胫股关节的受伤膝关节骨关节炎程度均向更高程度进展。与未受伤的腿相比，患者受伤腿的膝关节伸展力量明显更低（P = 0.011）。与参照人群相比，未观察到步态速度和步频有显著差异。膝关节骨关节炎、肌肉力量和步态模式与HRQOL无关（R < 0.35）。
髌骨骨折8.5年后，与年龄匹配的参照人群相比，HRQOL明显更差。
