Orthopedic Surgery and Rehabilitation, Evans Army Community Hospital, Fort Carson, Colorado.
Orthopedic Surgery, Emory University School of Medicine, Atlanta, Georgia.
J Knee Surg. 2024 Feb;37(3):175-182. doi: 10.1055/s-0043-1761201. Epub 2023 Jan 31.
The functional outcomes in patients undergoing patellofemoral arthroplasty (PFA) with high occupational demands have not been fully examined. This study assessed return to work and conversion to TKA rates following PFA in a young, military cohort. Patient demographics, pain scores, and surgical information were retrospectively collected for all active-duty military members who underwent PFA over a 4-year period. The data were then analyzed to calculate return to work, conversion to TKA, and perioperative complications rates. A total of 48 servicemembers with 60 total PFAs (36 unilateral, 12 bilateral) were included, with a mean follow up of 2.2 years. At the final follow-up, 83% of servicemembers returned to military service or completed their service obligation after PFA. Conversion to TKA occurred in three (6.2%) patients at an average of 2.4 years after PFA, resulting in a PFA annual revision rate of 2.3%. The mean numeric rating scale for pain improved from 4.9 ± 2.6 at baseline to 2.5 ± 2.0 postoperatively ( < 0.001). Servicemembers with at least one prior ipsilateral knee procedure had a significantly decreased odds ratio (OR) for both occupational outcome failure (OR, 0.03; 95% confidence interval [CI], 0-0.29) and overall failure (OR, 0.13; 95% CI, 0.02-0.78). At an average of 2 years following PFA, 83% of military members returned to duty, with a low rate of revision to TKA. Prior ipsilateral knee procedure decreased the probability of medical separation. LEVEL OF EVIDENCE: IV.
在职业需求较高的髌股关节成形术（PFA）患者中，功能结果尚未得到充分研究。本研究评估了年轻军人队列中 PFA 后重返工作岗位和转换为 TKA 的比率。对所有在 4 年内接受 PFA 的现役军人患者的人口统计学、疼痛评分和手术信息进行了回顾性收集。然后对数据进行分析，以计算重返工作岗位、转换为 TKA 以及围手术期并发症的比率。共纳入 48 名现役军人，共 60 例 PFA（36 例单侧，12 例双侧），平均随访 2.2 年。在最终随访时，83%的军人在 PFA 后重返军队服务或完成兵役义务。3 例（6.2%）患者在 PFA 后平均 2.4 年转换为 TKA，导致 PFA 每年翻修率为 2.3%。疼痛的平均数字评分量表从基线时的 4.9±2.6 改善至术后的 2.5±2.0（ < 0.001）。至少有一次同侧膝关节手术的军人，在职业结果失败（比值比 [OR]，0.03；95%置信区间 [CI]，0-0.29）和整体失败（OR，0.13；95%CI，0.02-0.78）的可能性显著降低。在 PFA 后平均 2 年，83%的军人返回工作岗位，TKA 翻修率较低。同侧膝关节手术史降低了医疗分离的概率。证据水平：IV。
