Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergerstr. 95, 72076, Tübingen, Germany.
AO Research Institute Davos, Clavadelerstr. 8, 7270, Davos, Switzerland.
BMC Musculoskelet Disord. 2019 Jan 22;20(1):34. doi: 10.1186/s12891-019-2400-z.
Patellar dislocation is common in young and active patients. The purpose of this study was to determine sporting activity following the medial reefing of patellar dislocation.
One hundred forty-four patients with objective patellar dislocation were treated between 2004 and 2013. Three groups were analyzed retrospectively with a minimum follow-up of 24 months: (1) primary dislocation that was treated with medial reefing without a recurrent dislocation until the day of follow-up (n = 74), (2) primary dislocation that was initially treated with medial reefing but with a recurrent dislocation until the day of follow-up (n = 44), and (3) medial reefing after failed conservative treatment (n = 26). Sporting activity was assessed using a widely-used sporting activity questionnaire and the Tegner score prior to the injury and at the follow-up (58.7 ± 22.6 months after the injury). Clinical outcomes were assessed using IKDC and Kujala score.
The Kujala score was 94.7 ± 9.3 for Group 1, 84.1 ± 16.6 for Group 2 and 93.4 ± 9.7 for Group 3. IKDC at the time of follow-up was 97.2 ± 9.3 for Group 1, 86.1 ± 14.6 for Group 2 and 95.1 ± 11.1 for Group 3. 91.9% of Group 1 and 92.3% of Group 3 were active in sports prior to their injuries and at the time of the follow-up. In Group 2, sporting activity reduced from 81.8 to 75.0%. In all groups, a shift from high performance to recreational sports was found.
Despite good clinical results, sporting activity was reduced following patellar dislocation treated with medial reefing. Also, a shift from engagement in high- to low-impact sports among the participants was noted.
髌骨脱位在年轻且活跃的患者中较为常见。本研究旨在确定内侧紧缩术治疗髌骨脱位后的运动活动情况。
2004 年至 2013 年间,对 144 例有客观髌骨脱位的患者进行了回顾性分析。对以下三组进行了分析,随访时间均至少为 24 个月:(1)初次脱位,采用内侧紧缩术治疗,随访日无再脱位(n=74);(2)初次脱位,采用内侧紧缩术治疗,但随访日有再脱位(n=44);(3)内侧紧缩术治疗失败后(n=26)。采用广泛使用的运动活动问卷和 Tegner 评分,在受伤前和随访时(受伤后 58.7±22.6 个月)评估运动活动情况。采用 IKDC 和 Kujala 评分评估临床结果。
第 1 组的 Kujala 评分为 94.7±9.3,第 2 组为 84.1±16.6,第 3 组为 93.4±9.7。随访时 IKDC 评分为第 1 组 97.2±9.3,第 2 组 86.1±14.6,第 3 组 95.1±11.1。第 1 组和第 3 组有 91.9%和 92.3%的患者在受伤前和随访时活跃于体育运动。第 2 组的运动活动从 81.8%下降到 75.0%。所有组中,都发现从高影响运动向低影响运动的转变。
尽管临床结果良好,但采用内侧紧缩术治疗髌骨脱位后,运动活动减少。同时,参与者也从从事高冲击运动转向低冲击运动。