Evaluation of practice patellofemoral instability collaborative (EPPIC)

IF 2 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-10-04 DOI:10.1016/j.knee.2025.06.015

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引用次数: 0

Abstract

Background

The management of patellofemoral instability in the United Kingdom remains poorly standardised. Through the British Association for Surgery of the Knee trainee collaborative, we aimed to identify which procedures (and in which combination) were being used to surgically manage this common condition across the UK.

Method

A retrospective national audit was conducted via a trainee collaborative analysing local trust data between 1st January 2014 and 31st December 2019. Data from institutions registered for the EPPIC audit was compiled and analysed for degree of compliance against more recently published national guidelines.

Results

Fifty (n = 50) sites submitted data, totalling 3189 skeletally mature patients. The median age was 26.7 (SD 0.5) years and 63.3 % were female. An isolated lateral release was performed in 8 %, an isolated medial patellofemoral ligament reconstruction (MPFLR) was performed in 37 % of patients and proximal realignment surgery was conducted in 8 % of patients. Trochleoplasty was required in 11 % of patients, with combined MPFLR and tibial tubercle osteotomy (TTO) being undertaken in 22 % of patients. Combined MPFLR, TTO and trochleoplasty was undertaken in 3 % of patients.

Conclusion

This audit highlights the national variation in surgical treatment of a common orthopaedic presentation. Despite the lack of evidence, an isolated lateral release is still being performed. There remains a lack of standardisation within the UK in the management of recurrent patellar instability, highlighting the need for national consensus of appropriate surgical interventions.

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髌骨不稳定协作（EPPIC）的评估。

背景：在英国，髌骨不稳的处理仍然缺乏标准化。通过英国膝关节手术协会的合作，我们的目标是确定哪些手术（以及哪些组合）被用来在英国手术治疗这种常见疾病。方法：通过实习生协作分析2014年1月1日至2019年12月31日期间的地方信托数据，进行回顾性国家审计。对EPPIC审计注册机构的数据进行了汇编和分析，以确定其符合最近发布的国家指导方针的程度。结果：50个（n = 50）站点提交了数据，共计3189例骨骼成熟患者。中位年龄26.7岁（SD 0.5）， 63.3%为女性。8%的患者进行了孤立的外侧松解，37%的患者进行了孤立的髌股内侧韧带重建（MPFLR）， 8%的患者进行了近端韧带重组手术。11%的患者需要行滑车成形术，22%的患者需要行MPFLR联合胫骨结节截骨术（TTO）。3%的患者接受了MPFLR、TTO和滑车成形术联合治疗。结论：这次审计突出了国家在外科治疗常见的骨科表现的差异。尽管缺乏证据，孤立侧位松解术仍在进行。在英国，复发性髌骨不稳的管理仍然缺乏标准化，这突出了对适当手术干预的全国共识的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.