MPFL 重建术后当前稳定性评分与术后患者满意度相关吗？
Do Current Stability Scores After MPFL Reconstruction Correlate With Patient Satisfaction Postoperatively?
机构信息
Department of Orthopedic Surgery, Loma Linda University Health, Loma Linda, California, USA.
Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
出版信息
Iowa Orthop J. 2022 Jun;42(1):187-192.
BACKGROUND
Patellar dislocation can lead to instability, pain, limited function, and recurrent dislocations. Medial patellofemoral ligament (MPFL) reconstruction leads to favorable patient reported outcomes, but many patients fail to return to previous activity levels. The purpose of this study is to determine how well patients do after MPFL reconstruction and to determine the most important factors for evaluation of patellar instability following MPFL reconstruction.
METHODS
After IRB approval, a retrospective chart review was performed on all patients who underwent MPFL reconstruction from January 2006 to January 2014 by two board-certified sports orthopaedic surgeons. Patients were then contacted to complete a follow-up questionnaire about satisfaction, functional status, pain, and patellar stability. Patients with at least one-year of follow-up data, a complete data set, and a completed questionnaire were included in the final analysis. Charts of 100 patients were reviewed and 54 patients met all criteria for inclusion in the study. Chi-square analysis, t-tests, and multivariate and univariate logistic regression models were used to estimate the effects of multiple variables on return to activity, satisfaction, and function while controlling for covariates with p<0.05 considered significant.
RESULTS
When asked about subluxation, 20% (11/54) reported recurrent patellar subluxation (without re-dislocation). Of the 11 patients who reported re-subluxation, 54% (6/11) reported being highly satisfied (rating of 9-10/10) with the outcome of their knee. Of the 54 patients, 54% (29/54) did not return to previous levels of activity, nevertheless, 31% (9/29) of these 29 patients reported being highly satisfied with the outcome of their knee.
CONCLUSION
Patients report high levels of satisfaction even if they have recurrent instability or are unable to return to prior activity levels. Current scoring systems do not accurately depict patients' post-operative outcomes after MPFL Reconstruction. .
背景
髌骨脱位可导致不稳定、疼痛、功能受限和反复脱位。内侧髌股韧带（MPFL）重建可导致患者报告的结果良好，但许多患者无法恢复到以前的活动水平。本研究的目的是确定 MPFL 重建后患者的表现，并确定评估 MPFL 重建后髌骨不稳定的最重要因素。
方法
在获得机构审查委员会（IRB）批准后，对两位经过董事会认证的运动骨科医生在 2006 年 1 月至 2014 年 1 月期间进行的所有 MPFL 重建患者进行了回顾性图表审查。然后联系患者完成关于满意度、功能状态、疼痛和髌骨稳定性的随访问卷。至少有一年随访数据、完整数据集和完整问卷的患者被纳入最终分析。对 100 例患者的图表进行了审查，其中 54 例患者符合纳入研究的所有标准。使用卡方分析、t 检验以及多变量和单变量逻辑回归模型来估计多个变量对活动回归、满意度和功能的影响，同时控制协变量，p<0.05 被认为具有统计学意义。
结果
当被问及髌骨半脱位时，20%（11/54）的患者报告有复发性髌骨半脱位（无再脱位）。在报告再半脱位的 11 名患者中，54%（6/11）对他们的膝关节结果非常满意（评分 9-10/10）。在 54 名患者中，54%（29/54）未恢复到以前的活动水平，但其中 31%（9/29）的患者对他们的膝关节结果非常满意。
结论
即使患者有反复的不稳定或无法恢复到以前的活动水平，他们也会报告较高的满意度。目前的评分系统并不能准确描述 MPFL 重建后患者的术后结果。
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