Department of Surgery, Central Finland Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland.
Department of Emergency, Anaesthesia and Pain Medicine, Tampere University Hospital, Tampere, Finland.
Knee Surg Sports Traumatol Arthrosc. 2021 Jun;29(6):1944-1951. doi: 10.1007/s00167-020-06277-x. Epub 2020 Sep 18.
Increasing knowledge on the treatment of patellar dislocation has resulted in the development of new surgical techniques for patella stabilisation. National incidence and trends in surgery for patellar dislocation were examined using data from the Finnish National Hospital Discharge Register (NHDR). The hypothesis was that an increased understanding of the pathophysiology of patellar instability has increased the popularity of reconstructing damaged structures and modification of anatomical risk factors.
Data from the years 1997-2016 were collected from the NHDR database using ICD-10 diagnostic codes and the Nomesco Classification of Surgical Procedures (NCSP) codes. Surgical procedures were categorised into subgroups representing the main surgical approaches of patellar dislocation. Total incidence of surgery for patellar dislocation and change in incidence during the study period were calculated.
A total of 9702 operations for patellar dislocation were performed during the study period. Median (IQR) patient age at time of primary surgery was 23 (18-34) years. The total incidence of surgeries remained stable across the study period at of 8.9 per 100,000 person-years. Incidences of ligament reconstruction, femoral osteotomies and osteochondral fragment reimplantation operations multiplied during the study period. Ligament reconstruction procedures were the most performed operations at the end of the study period.
The incidence of surgical procedures for patellar dislocation remained unchanged during the years 1997-2016. Ligament reconstruction procedures increased in popularity. Surgical techniques have shifted towards the reconstruction of damaged structures and the modification of congenital anatomical risk factors for patellar dislocation. Diversified surgical techniques have enabled the tailoring and combining of stabilizing procedures according to the patient's individual anatomy.
对髌骨脱位治疗的认识不断提高，促进了髌骨稳定化的新手术技术的发展。本研究使用芬兰国家住院患者登记数据库（NHDR）的数据，调查了髌骨脱位手术的国家发病率和趋势。假设是对髌骨不稳定病理生理学的理解增加，促进了对受损结构的重建和解剖学危险因素的修正。
使用 ICD-10 诊断代码和 Nomesco 手术分类（NCSP）代码从 NHDR 数据库中收集了 1997 年至 2016 年的数据。将手术分为代表髌骨脱位主要手术方法的亚组。计算了髌骨脱位手术的总发病率和研究期间发病率的变化。
在研究期间共进行了 9702 例髌骨脱位手术。初次手术时患者的中位（IQR）年龄为 23（18-34）岁。整个研究期间，手术总发病率保持稳定，为每 100,000 人年 8.9 例。重建韧带、股骨截骨和骨软骨碎片再植入手术的发病率在研究期间呈倍增趋势。重建韧带手术是研究期末最常进行的手术。
1997-2016 年，髌骨脱位手术的发病率保持不变。重建韧带手术的应用日益普及。手术技术已转向对受损结构的重建和对髌骨脱位先天性解剖学危险因素的修正。多样化的手术技术能够根据患者的个体解剖结构进行稳定化手术的定制和组合。
