Heyniger John, Ward Jacob, Flanigan David C, Milliron Eric M, Cavendish Parker A, Kaeding Christopher C, Magnussen Robert A
The Ohio State University, Columbus, Ohio, USA.
Orthop J Sports Med. 2025 Jul 15;13(7):23259671251324495. doi: 10.1177/23259671251324495. eCollection 2025 Jul.
Medial patellofemoral ligament (MPFL) reconstruction is a common procedure to treat recurrent patellar instability. Outcomes in older patients after this procedure have been less frequently reported in the literature.
Patients ≥30 years of age would demonstrate similar subsequent dislocation risk and patient-reported outcomes (PROs) after MPFL reconstruction to younger patients.
Cohort study; Level of evidence, 3.
A retrospective review was undertaken to identify patients who underwent isolated MPFL reconstruction between 2008 and 2020. Patients were categorized into 2 groups based on age ≥30 years or <30 years at the time of surgery. Subsequent patellar dislocation risk and PROs (Knee injury and Osteoarthritis Outcome Score [KOOS], Norwich score, and Marx activity score) were compared between groups. PROs were compared controlling for anatomic and other demographic differences between groups.
A total of 228 patients underwent isolated MPFL reconstruction in the study period; 177 patients (78%) were assessed for subsequent patellar dislocation a minimum of 1 year postoperatively (median, 3.4 years). The study included 140 patients <30 years of age at surgery and 37 patients ≥30 years of age at surgery. Subsequent dislocation occurred in 9 patients (5.1%), including 7 patients <30 years (5.0% subsequent dislocation risk) and 2 patients ≥30 years (5.4% subsequent dislocation risk; > .99). In total, 147 patients completed PRO score surveys at a median of 3.8 years postoperatively. Patients ≥30 years at surgery (n = 31) had poorer KOOS pain (82.1 vs 91.7; = .03), KOOS activities of daily living (94.1 vs 97.1; = .04), and Marx activity score (1 vs 7; < .001) compared with the patients <30 years (n = 116). After adjusting for anatomic and demographic factors, KOOS pain subscale values were significantly poorer for patients ≥30 years (β = -4.3; 95% CI, -8.3 to -0.2; = .04). No differences in Norwich score or other KOOS subscale values were noted.
Patients ≥30 years at the time of MPFL reconstruction demonstrate similar subsequent dislocation risk but poorer KOOS pain subscale and Marx activity values than patients <30 years at the time of MPFL reconstruction.
髌股内侧韧带（MPFL）重建是治疗复发性髌骨不稳的常见手术。该手术在老年患者中的疗效在文献中报道较少。
年龄≥30岁的患者在MPFL重建术后的后续脱位风险和患者报告结局（PROs）与年轻患者相似。
队列研究；证据等级，3级。
进行回顾性研究，以确定2008年至2020年间接受单纯MPFL重建的患者。根据手术时年龄≥30岁或<30岁将患者分为两组。比较两组之间的后续髌骨脱位风险和PROs（膝关节损伤和骨关节炎结局评分[KOOS]、诺维奇评分和马克思活动评分）。在控制两组之间的解剖学和其他人口统计学差异的情况下比较PROs。
在研究期间，共有228例患者接受了单纯MPFL重建；177例患者（78%）在术后至少1年接受了后续髌骨脱位评估（中位数，3.4年）。该研究包括140例手术时年龄<30岁的患者和37例手术时年龄≥30岁的患者。9例患者（5.1%）发生了后续脱位，其中7例年龄<30岁（后续脱位风险为5.0%），2例年龄≥30岁（后续脱位风险为5.4%；P>.99）。共有147例患者在术后中位数3.8年时完成了PRO评分调查。手术时年龄≥30岁的患者（n = 31）与手术时年龄<30岁的患者（n = 116）相比，KOOS疼痛评分（82.1对91.7；P = .03）、KOOS日常生活活动评分（94.1对97.1；P = .04）和马克思活动评分（1对7；P<.0oo1）较差。在调整了解剖学和人口统计学因素后，年龄≥30岁的患者KOOS疼痛子量表值明显较差（β = -4.3；95%CI，-8.3至-0.2；P = .o4）。诺维奇评分或其他KOOS子量表值未发现差异。
MPFL重建时年龄≥30岁的患者显示出相似的后续脱位风险，但与MPFL重建时年龄<30岁的患者相比，KOOS疼痛子量表和马克思活动值较差。
