股四头肌内侧肌腱股韧带重建术与髌股内侧韧带重建术在治疗髌骨外侧不稳的临床疗效上无显著差异:一项匹配队列研究

IF 2.7 Q1 ORTHOPEDICS
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引用次数: 0

摘要

研究目的本研究旨在比较复发性髌骨外侧不稳患者接受内侧股四头肌腱-股骨韧带重建术(MQTFLR)和内侧髌骨-股骨韧带重建术(MPFLR)的临床疗效:我们进行了一项回顾性配对队列研究,涉及2019-2021年期间接受或未接受胫骨结节截骨术(TTO)的MQTFLR或MPFLR患者。受试者的年龄、同时接受的骨软骨异体移植(OCA)、同时接受的TTO和随访时间均为1:1匹配。测量结果包括90天并发症、视觉模拟量表(VAS)膝关节疼痛、恢复运动/工作、Kujala评分、Tegner评分和MPFL-受伤后恢复运动(MPFL-RSI)评分。对连续变量采用 Mann-Whitney U 检验,对分类变量采用 Fisher's 精确检验,比较组间结果。P值 结果:研究共纳入 10 名 MQTFLR 患者(平均年龄 28.7 岁,80% 为女性,平均随访 19.7 个月)和 10 名 MPFLR 患者(平均年龄 29.1 岁,90% 为女性,平均随访 28.3 个月)。一名 MQTFLR 患者(10%)和三名 MPFLR 患者(30%)因术后关节纤维化而再次手术。两组患者术后 VAS 静息痛无明显差异(MQTFLR 平均为 1.1,MPFLR 平均为 0.6,P=0.31)。复发性半脱位率(MQTFLR 20%,MPFLR 0%,P=0.47)、恢复运动率(MQTFLR 50%,MPFLR 75%,P=0.61)、恢复工作率(MQTFLR 100%,MPFLR 88%,P=1.00)或MPFL-RSI通过率(MQTFLR 75% vs. MPFLR 38%,P=0.31)无明显差异:结论:接受MQTFLR与接受MPFLR的患者在膝关节疼痛和功能、重返工作岗位以及复发性髌骨不稳的发生率方面没有明显差异,但鉴于样本量较小和潜在的选择偏差,这些结果应谨慎解读:证据等级:III。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medial quadriceps tendon femoral ligament reconstruction and medial patellofemoral ligament reconstruction have no significant differences in clinical outcomes for treatment of lateral patellar instability: a matched-cohort study

Objectives

The purpose of this study was to compare clinical outcomes of medial quadriceps tendon-femoral ligament reconstruction (MQTFLR) and medial patellofemoral ligament reconstruction (MPFLR) among patients with recurrent lateral patellar instability.

Methods

A retrospective matched-cohort study was conducted involving patients who underwent MQTFLR or MPFLR with or without tibial tubercle osteotomy (TTO) from 2019 to 2021. Subjects were matched 1:1 on age, concomitant osteochondral allograft (OCA), concomitant TTO, and follow-up time. Measured outcomes included 90-day complications, Visual Analog Scale (VAS) knee pain, return to sport/work, Kujala score, Tegner score, and MPFL-Return to Sport after Injury (MPFL-RSI) score. Outcomes were compared between groups using Mann–Whitney U-test for continuous variables and Fisher's exact test for categorical variables. P-values <0.05 were considered significant.

Results

Ten MQTFLR patients (mean age 28.7 years, 80% female, mean follow-up 19.7 months) and ten MPFLR patients (mean age 29.1 years, 90% female, mean follow-up 28.3 months) were included in the study. One MQTFLR patient (10%) and three MPFLR patients (30%) underwent reoperation for postoperative arthrofibrosis. Postoperative VAS resting pain was not significantly different between the groups (MQTFLR mean 1.1, MPFLR mean 0.6, p ​= ​0.31). There were no significant differences in rates of recurrent subluxations (MQTFLR 20%, MPFLR 0%, p ​= ​0.47), return to sport (MQTFLR 50%, MPFLR 75%, p ​= ​0.61), return to work (MQTFLR 100%, MPFLR 88%, p ​= ​1.00), or MPFL-RSI pass rate (MQTFLR 75% vs. MPFLR 38%, p ​= ​0.31).

Conclusion

There were no significant differences in knee pain and function, return to work, and rates of recurrent patellar instability between patients who underwent MQTFLR versus MPFLR, though these results should be interpreted with caution given the small sample size and potential selection bias.

Level of Evidence

III.

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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
61
审稿时长
108 days
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