Lashgari Alexander, Furgiuele David L, Ganta Abhishek, Konda Sanjit, Egol Kenneth A
NYU Langone Orthopedic Hospital, NYU Langone Health, New York, USA.
Jamaica Hospital Medical Center, Queens, USA.
Eur J Orthop Surg Traumatol. 2025 Jun 26;35(1):280. doi: 10.1007/s00590-025-04380-8.
The purpose of this study was to evaluate the short-term postoperative outcomes of patients undergoing patella open reduction internal fixation procedures based on the type of anesthesia administered.
A retrospective review was conducted of patients who were surgically treated for displaced patella fractures from 2012 to 2024 at a single multi-site academic institution. Patients were included if they were > 18 years of age, sustained an isolated patella fracture, and had a minimum of 6-month follow-up. Patients were divided into groups based on the anesthetic modality used during their surgery: regional anesthesia only (RA), general/neuraxial anesthesia (NR), and a combination of these methods (CA). Comparisons of statistics were performed using Pearson chi-squared tests, one-way ANOVA tests, and linear regression tests as appropriate.
There were no complications associated with the administration of anesthesia within each cohort. There was no significant difference in fracture healing rates (p = .210) nor complication rates between the anesthesia groups (p = .088). The RA and CA groups had significantly shorter operating room (wheels in to wheels out) times than the NR group (p < .001), significantly greater 3-month (p = .001) and 6-month knee ROM (p = .016) than the NR group when controlling for age, fracture pattern, and repair method.
This study demonstrates the efficacy of the use of regional anesthesia only for repair of a patella fracture. This technique is associated with greater early range of knee motion in patients after surgery and a shorter surgical time with no increase in intra or postoperative complications.
本研究的目的是根据所采用的麻醉类型评估接受髌骨切开复位内固定手术患者的术后短期结局。
对2012年至2024年在一家多地点学术机构接受手术治疗的移位髌骨骨折患者进行回顾性研究。纳入标准为年龄大于18岁、单纯髌骨骨折且至少随访6个月的患者。根据手术期间使用的麻醉方式将患者分为几组：仅区域麻醉（RA）、全身/神经轴麻（NR）以及这些方法的联合使用（CA）。根据情况使用Pearson卡方检验、单因素方差分析和线性回归检验进行统计比较。
每个队列中麻醉给药均未出现并发症。麻醉组之间的骨折愈合率（p = 0.210）和并发症发生率（p = 0.088）均无显著差异。在控制年龄、骨折类型和修复方法后，RA组和CA组的手术室（推入到推出）时间明显短于NR组（p < 0.001），3个月（p = 0.001）和6个月时的膝关节活动度（p = 0.016）明显大于NR组。
本研究证明了仅使用区域麻醉修复髌骨骨折的有效性。该技术与术后患者早期膝关节活动范围更大以及手术时间更短相关，且术中及术后并发症未增加。
