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尽管膝关节功能仍存在一定限制,但内侧髌股韧带重建术后患者的自我报告和基于表现的结果表明,膝关节稳定性得到了成功改善。

Self-reported and performance-based outcomes following medial patellofemoral ligament reconstruction indicate successful improvements in knee stability after surgery despite remaining limitations in knee function.

机构信息

Department of Orthopaedics, Clinical Sciences, Skåne University Hospital, Malmö, Sweden.

Department of Orthopaedics, Clinical Sciences, Lund University Hospital, Lund, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Mar;28(3):934-940. doi: 10.1007/s00167-019-05570-8. Epub 2019 Jun 24.

Abstract

PURPOSE

To evaluate short- to midterm outcomes of medial patellofemoral ligament reconstruction (MPFL) using patient-reported outcome measures and functional testing.

METHODS

Twenty-four patients were examined regarding knee function after MPFL reconstruction, with a mean follow-up time of 45.3 ± 18.4 months since surgery. Knee function was evaluated using the Tegner score, VAS, the knee injury and osteoarthritis outcome score (KOOS), the Lysholm score, SF-36 and EQ-5D-3L as well as functional scores. A group of uninjured persons of the same age and same gender composition was used for comparison.

RESULTS

Eight (40%) patients managed to return to their pre-injury activity level. Five (25%) patients stated that they had experienced further patella dislocations after surgery but only two (10%) had sought medical help. Patients showed significantly poorer results in all PROMs compared to controls. The results obtained with SF-36 showed significant differences in physical health between the groups, but not in mental health. The functional performance test results showed overall poorer results for the patients versus controls: 11.5 sets for the square jump (6.7-15.7) versus 21 sets (18-26), 11.5 sets for the step-down test (6.5-15) versus 22 sets (18-26), and 77 cm for the single-leg hop for distance (32.2-110.5) versus 126 cm (115-37); all (P < 0.005).

CONCLUSIONS

After MPFL reconstruction, patients do not regain normal knee function, as measured by PROMs and functional tests, compared to an uninjured control group. Patients should be informed about residual functional limitations despite improved stability.

LEVEL OF EVIDENCE

III.

摘要

目的

使用患者报告的结果测量和功能测试来评估内侧髌股韧带重建(MPFL)的短期至中期结果。

方法

对 24 例接受 MPFL 重建后的患者进行膝关节功能检查,自手术以来的平均随访时间为 45.3±18.4 个月。使用 Tegner 评分、VAS、膝关节损伤和骨关节炎结果评分(KOOS)、Lysholm 评分、SF-36 和 EQ-5D-3L 以及功能评分评估膝关节功能。还使用了一组相同年龄和相同性别组成的未受伤者作为对照组。

结果

8 例(40%)患者能够恢复到受伤前的活动水平。5 例(25%)患者表示手术后曾经历过髌骨再次脱位,但只有 2 例(10%)寻求了医疗帮助。与对照组相比,患者在所有 PROM 中的结果明显较差。SF-36 获得的结果表明,两组之间在身体健康方面存在显著差异,但在心理健康方面没有差异。功能表现测试结果显示,与对照组相比,患者的总体表现较差:方形跳跃测试 11.5 组(6.7-15.7)对 21 组(18-26),下台阶测试 11.5 组(6.5-15)对 22 组(18-26),单腿跳远距离测试 77cm(32.2-110.5)对 126cm(115-37);所有结果(P<0.005)。

结论

与未受伤的对照组相比,MPFL 重建后,患者的膝关节功能无法通过 PROM 和功能测试恢复正常。尽管稳定性得到改善,但患者应被告知存在残余的功能限制。

证据水平

III 级。

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