拥有住房、全职工作以及其他较高社会经济地位的标志，预示着在接受髌股内侧韧带重建的外侧髌股关节不稳患者中，从初次评估到手术的时间更短，术后效果更好。
Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction.
作者信息
Shankar Dhruv S, Avila Amanda, DeClouette Brittany, Vasavada Kinjal D, Jazrawi Isabella B, Alaia Michael J, Gonzalez-Lomas Guillem, Strauss Eric J, Campbell Kirk A
机构信息
Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA.
出版信息
Knee Surg Relat Res. 2023 Jul 17;35(1):20. doi: 10.1186/s43019-023-00193-3.
BACKGROUND
The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR).
METHODS
We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection.
RESULTS
Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03).
CONCLUSION
Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes.
LEVEL OF EVIDENCE
IV, retrospective case series.
背景
本研究的目的是确定接受内侧髌股韧带重建术（MPFLR）的外侧髌股关节不稳患者初始评估时间、手术时间和术后结果的社会经济预测因素。
方法
我们对2011年至2019年在本机构接受同种异体移植初次MPFLR且随访至少12个月的患者进行了回顾性研究。2022年1月，我们通过电子邮件对患者进行了调查，以评估症状史、社会经济状况以及包括视觉模拟评分法（VAS）满意度和库贾拉评分在内的术后结果。采用逐步选择的多变量线性和逻辑回归分析确定初始评估时间、手术时间和术后结果的预测因素。
结果
该队列纳入了70例患者（平均年龄24.8岁，72.9%为女性，平均随访时间45.7个月）。平均评估时间为6.4个月（范围0 - 221个月），平均手术时间为73.6个月（范围0 - 444个月）。术前一年进行全面健康检查可预测初始评估时间较短（β = - 100.5 [- 174.5, - 26.5]，p = 0.008）。拥有自有住房可预测手术时间较短（β = - 56.5 [- 104.7, 8.3]，p = 0.02）。全职工作可预测更高的VAS满意度（β = 14.1 [4.3, 23.9]，p = 0.006）和更高的库贾拉评分（β = 8.7 [0.9, 16.5]，p = 0.03）。
结论
较高社会经济地位的标志，包括术前一年进行全面检查、拥有自有住房和全职工作，可预测初始评估时间较短、手术时间较短和更好的术后结果。
证据水平
IV级，回顾性病例系列研究。
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