Department for Orthopedic Sports Medicine, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Orthopedics and Trauma Surgery, Medical Center, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2021 Sep;29(9):3017-3024. doi: 10.1007/s00167-020-06340-7. Epub 2020 Oct 29.
To analyze postoperative physical and sexual activity as well as Quality of Life (QoL) after complex patellofemoral reconstructions in female patients suffering from chronic patellofemoral instability (PFI).
Female patients aged > 18 years undergoing complex patellofemoral reconstruction for chronic PFI were included. Complex patellofemoral reconstruction was defined as medial patellofemoral ligament reconstruction (MPFL-R) combined with at least one major bony procedure (distal femoral osteotomy, high tibial osteotomy, and trochleoplasty). Outcome was evaluated retrospectively after a minimum follow-up of 12 months using Tegner activity scale, Banff Patellofemoral Instability Instrument 2.0 (BPII 2.0), EuroQol-5D-3L (EQ-5D-3L), EuroQol Visual analog scale (EQ-VAS), and a questionnaire about sexual activity.
A total of 34 females (mean age, 26 ± 5 years) with a mean follow-up of 45 ± 16 months were included. Seventy-seven percent had one major bony correction + MPFL-R and 24% had at least two major bony corrections + MPFL-R. The re-dislocation rate was 6%. Median Tegner activity scale improved from 3 (range 0-10) to 4 (range 2-6) (n.s.) and an improved activity level was observed in 49% of subjects. QoL scores showed an EQ-5D-3L Index Value of 0.89 ± 0.15, EQ-VAS of 80.3 ± 11.4, and BPII of 68.3 ± 19.1. Thirty-four percent of patients reported restrictions of sexual activities due to PFI preoperatively with an improved sexual function observed in 60% postoperatively due to less pain, improved mobility, and less apprehension. Postoperative return to sexual activity was 91%, whereof 19% reported current restrictions of sexual function because of pain and/or limited range of motion.
Despite the complexity and invasiveness of complex patellofemoral reconstruction, combined bony procedures and MPFL-R resulted in a low redislocation rate, improved physical activity and QoL comparable to values reported after isolated MPFL-R. Furthermore, sexual activity was improved in 60% of females with preoperative restrictions.
IV.
分析女性慢性髌股关节不稳定（PFI）患者接受复杂髌股重建术后的身体活动和性功能，以及生活质量（QoL）。
纳入年龄>18 岁的女性患者，接受复杂髌股重建术治疗慢性 PFI。复杂髌股重建术定义为内侧髌股韧带重建（MPFL-R）联合至少一种主要的骨手术（股骨远端截骨术、胫骨高位截骨术和滑车成形术）。使用 Tegner 活动量表、Banff 髌股不稳定量表 2.0（BPII 2.0）、EuroQol-5D-3L（EQ-5D-3L）、EuroQol 视觉模拟量表（EQ-VAS）和一份关于性行为的问卷，对至少 12 个月的随访结果进行回顾性评估。
共纳入 34 名女性（平均年龄 26±5 岁），平均随访 45±16 个月。77%的患者接受了一种主要的骨性矫正+MPFL-R，24%的患者接受了至少两种主要的骨性矫正+MPFL-R。再脱位率为 6%。Tegner 活动量表中位数从 3（范围 0-10）提高到 4（范围 2-6）（无统计学意义），49%的患者活动水平提高。QoL 评分显示 EQ-5D-3L 指数值为 0.89±0.15，EQ-VAS 为 80.3±11.4，BPII 为 68.3±19.1。34%的患者术前因 PFI 限制了性行为，60%的患者术后由于疼痛减轻、活动度改善和担忧减少，性功能改善。术后恢复性行为的比例为 91%，其中 19%的患者因疼痛和/或活动范围受限而报告目前存在性行为受限。
尽管复杂髌股重建术具有复杂性和侵袭性，但联合骨手术和 MPFL-R 可降低再脱位率，提高身体活动能力和 QoL，与孤立性 MPFL-R 后报告的值相当。此外，60%术前存在活动受限的女性患者的性功能得到改善。
IV。
