髌股关节成形术后恢复运动和娱乐活动：系统回顾。

IF 3.3 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-07-08 DOI:10.1016/j.jisako.2025.100925

José Arteaga MD, MSc , Eduardo Poblete MD , Fernando Martin MD , Gabriel Domecq MD , David Figueroa MD, Prof.

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引用次数: 0

摘要

重要性：髌股关节成形术（PFA）是孤立性髌股骨关节炎的一种成熟治疗方法。然而，关于术后活动水平和运动恢复（RTS）的证据仍然有限。目的：评估PFA后RTS和娱乐活动率，确定影响这些结果的因素，并报告相关并发症。证据回顾：根据PRISMA指南，于2024年6月对PubMed、EMBASE、ScienceDirect和Scopus进行了系统检索。搜索词包括“髌股关节成形术”、“身体活动”和“重返运动”。如果研究报告了PFA后的RTS结果，则纳入研究。排除了缺乏RTS数据或单独PFA结果的研究。从492条记录中，有7项研究符合纳入标准。结果：7项研究（2项前瞻性研究，5项回顾性研究），包括265例患者(281个膝关节；64.6%的女性;平均年龄48.9岁)，平均随访5.3年。RTS的定义各不相同，报告的比率从64.7%到91%不等。低冲击运动更常恢复，58.6%的患者在6个月内恢复运动。在返回者中，74.8%达到或超过术前活动水平。术后疼痛得到改善（VAS从6.3到2.7），尽管高达38.6%的患者报告疼痛受限活动。全膝关节置换术的发生率为6.3%至13%，再手术率为10.4%至25%。局限性包括不一致的RTS定义、异质的结果报告和使用非标准化问卷。结论：大多数PFA患者可以恢复运动和娱乐活动，特别是低冲击活动。应该积极处理疼痛管理。需要有标准化RTS定义的高质量研究来评估活动对植入物存活的长期影响。相关性：PFA后的RTS是安全且可实现的。个性化的方法对于优化RTS和管理患者期望至关重要。证据等级：III。

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Return to sports and recreational activities after patellofemoral arthroplasty: A systematic review

Importance

Patellofemoral arthroplasty (PFA) is an established treatment for isolated patellofemoral osteoarthritis. However, evidence regarding postoperative activity levels and return to sport (RTS) remains limited.

Objective

The objective of this study was to evaluate RTS and recreational activity rates following PFA, identify factors influencing these outcomes, and report associated complications.

Evidence review

A systematic search was conducted in June 2024 across PubMed, EMBASE, ScienceDirect, and Scopus databases, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included variations of “patellofemoral arthroplasty,” “physical activity,” and “return to sport.” Studies were included if they reported RTS outcomes following PFA. Studies lacking RTS data or isolated PFA results were excluded. From 492 records, 7 studies met the inclusion criteria.

Findings

Seven studies (2 prospective and 5 retrospective) comprising 265 patients (281 knees; 64.6% women; mean age: 48.9 years) were included, with a mean follow-up of up to 5.3 years. RTS definitions varied, with reported rates ranging from 64.7% to 91%. Low-impact sports were more commonly resumed, and 58.6% of patients returned to sport within six months. Among those who returned, 74.8% reached or exceeded their preoperative activity level. Postoperative pain improved (visual analog scale scores decreased from 6.3 to 2.7), although up to 38.6% of patients reported pain limiting activity. Conversion to total knee arthroplasty occurred in 6.3% to 13% of cases, and reoperation rates ranged from 10.4% to 25%. Limitations included inconsistent RTS definitions, heterogeneous outcome reporting, and use of non-standardized questionnaires.

Conclusions

RTS and recreational activity after PFA can be resumed by most patients, especially low-impact activities. Pain management should be actively addressed. High-quality studies with standardized RTS definitions are needed to evaluate the long-term impact of activity on implant survival.