Lyons Joseph G, Mian Humza M, Via Garrhett G, Brueggeman David A, Krishnamurthy Anil B
Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
Phys Sportsmed. 2023 Apr;51(2):183-192. doi: 10.1080/00913847.2021.2024775. Epub 2022 Jan 6.
Injuries to the native extensor mechanism (EM) of the knee are potentially disabling and often require surgical treatment. Large-scale, updated epidemiological data on these injuries is lacking. The objective of the current study was to examine recent trends in EM injuries presenting to United States (US) Emergency Departments (EDs) over the last 20 years using a nationally representative sample.
This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database to identify cases of EM injuries (defined as either a quadriceps tendon rupture, a patella fracture, or a patellar tendon rupture) presenting to EDs in the US from 2001 to 2020.
During the study period, an estimated 214,817 EM injuries occurred in an at-risk population of 6,183,899,410 person-years for an overall incidence rate of 3.47 per 100,000 person-years. Patella fractures (PFs) were the most common injury type, representing 77.5% of all EM injuries (overall incidence rate: 2.69), followed by patellar tendon ruptures (PTRs; 13.5%; incidence: 0.48) and quadriceps tendon ruptures (QTRs; 9%; incidence: 0.31). Demographic characteristics and mechanisms of injury differed between injury types. Annual incidence rates increased significantly during the study period for all EM injury types, with PTRs demonstrating the largest relative increase (average annual percent increase: PF, 2.8%; PTR, 7.2%; QTR, 5.3%). Accounting for population growth yielded an increasing incidence of all EM injuries combined from 3.65 in 2001 to 4.9 in 2020. The largest relative increases in incidence rates were observed in older age groups.
Extensor mechanism injuries of the knee are increasing in the US, which likely reflects an aging and more active population. These types of injuries are associated with substantial functional impairment and recent increases in incidence rates highlight the need for injury prevention and management strategies.
膝关节原有的伸肌机制（EM）损伤可能导致残疾，且通常需要手术治疗。目前缺乏关于这些损伤的大规模、更新的流行病学数据。本研究的目的是使用具有全国代表性的样本，研究过去20年中美国急诊科（ED）收治的EM损伤的近期趋势。
本研究回顾性分析了国家电子伤害监测系统（NEISS）数据库，以确定2001年至2020年期间美国急诊科收治的EM损伤病例（定义为股四头肌肌腱断裂、髌骨骨折或髌腱断裂）。
在研究期间，估计在6,183,899,410人年的高危人群中发生了214,817例EM损伤，总体发病率为每100,000人年3.47例。髌骨骨折（PF）是最常见的损伤类型，占所有EM损伤的77.5%（总体发病率：2.69），其次是髌腱断裂（PTR；13.5%；发病率：0.48）和股四头肌肌腱断裂（QTR；9%；发病率：0.31）。不同损伤类型的人口统计学特征和损伤机制有所不同。在研究期间，所有EM损伤类型的年发病率均显著增加，其中PTR的相对增幅最大（平均年增长率：PF为2.8%；PTR为7.2%；QTR为5.3%）。考虑到人口增长，所有EM损伤合并后的发病率从2001年的3.65上升至2020年的4.9。发病率相对增幅最大的是老年人群体。
美国膝关节伸肌机制损伤呈上升趋势，这可能反映了人口老龄化和人口更加活跃。这些类型的损伤与严重的功能障碍相关，近期发病率的增加凸显了预防和管理损伤策略的必要性。
