The Department of Orthopaedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway.
Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
BMC Musculoskelet Disord. 2019 Jul 8;20(1):318. doi: 10.1186/s12891-019-2689-7.
Surgical treatment of young patients with recurrent lateral patella dislocation (RLDP) is often recommended because of loss of knee function that compromises their level of activity or even their daily life functioning. This situation is comparable to young patients with an anterior cruciate ligament (ACL) rupture. The purpose of this study was therefore to explore the time from injury to surgery and the pre-operative symptoms and knee function of young RLPD patients scheduled for stabilizing surgery and compare this group to age and sex-matched ACL-deficient patients.
Forty-seven patients with unilateral RLPD listed for isolated medial patellofemoral ligament reconstruction were included in the study (RLPD-group). This group was compared to an age, sex and BMI matched ACL patient group obtained from the Norwegian knee ligament registry (ACL-group) for the following outcome measures: the knee injury and osteoarthritis outcome score (KOOS) assessed on the day of surgery and time from injury to surgery.
The RLPD-group scored significantly lower than the ACL-group for the three KOOS subscales "Pain" (73.6 vs. 79.8, p < 0.05), "Symptoms" (71.7 vs. 79.3, p < 0.05) and "ADL" (84.7 vs 89.5, p < 0.05). The lowest KOOS values were found for Sports/Recreation (53.5 vs. 51.3, p = 0.65) and Quality of life (37.6 vs. 36.7, p = 0.81). The average time from primary injury to surgery was 6 months for the ACL group and 31 months for the RLPD group.
RLPD affected knee function as much as ACL deficiency, and was associated with more pain. Still the RLDP patients waited on average 5 times longer for surgery.
The patients with RLPD consisted of patients who were examined for possible recruitment for a concurrent prospective randomized controlled trial comparing conservative treatment and isolated surgical medial patellofemoral ligament (MPFL) reconstruction (Clinical trials no: NCT02263807 , October 2014).
对于复发性外侧髌骨脱位（RLDP）的年轻患者，常建议进行手术治疗，因为膝关节功能丧失会影响其活动水平，甚至影响日常生活功能。这种情况类似于前交叉韧带（ACL）断裂的年轻患者。因此，本研究旨在探讨接受稳定手术的年轻 RLPD 患者从受伤到手术的时间以及术前症状和膝关节功能，并将该组与年龄和性别匹配的 ACL 缺失患者进行比较。
纳入 47 例单侧 RLPD 患者，拟行单纯内侧髌股韧带重建术（RLPD 组）。该组与挪威膝关节韧带登记处获得的年龄、性别和 BMI 匹配的 ACL 患者组（ACL 组）进行比较，以评估以下结果测量：手术当天的膝关节损伤和骨关节炎结果评分（KOOS）和从受伤到手术的时间。
RLPD 组在 KOOS 的三个亚量表“疼痛”（73.6 对 79.8，p < 0.05）、“症状”（71.7 对 79.3，p < 0.05）和“ADL”（84.7 对 89.5，p < 0.05）方面的评分明显低于 ACL 组。运动/娱乐（53.5 对 51.3，p = 0.65）和生活质量（37.6 对 36.7，p = 0.81）的 KOOS 值最低。ACL 组的平均手术时间为 6 个月，RLPD 组为 31 个月。
RLPD 对膝关节功能的影响与 ACL 缺失相同，且疼痛更严重。然而，RLDP 患者的平均手术等待时间长了 5 倍。
RLPD 患者包括接受检查以招募参加一项比较保守治疗和单纯内侧髌股韧带（MPFL）重建的前瞻性随机对照试验的患者（临床试验编号：NCT02263807，2014 年 10 月）。
