Patient-reported outcomes following patella fractures : a nationwide observational study of 8,726 patients from the Swedish Fracture Register.

Aims: Patella fractures can greatly impact knee function and quality of life. The primary aim of this study was to assess patient-reported outcomes one-year post-patella fracture. A secondary aim was to evaluate outcome differences based on sex, age, fracture classification, treatment modality, and patients' expectations.

Methods: This observational study included all patients aged ≥ 18 years at injury with a registered patella fracture in the Swedish Fracture Register between 1 January 2011 and 31 December 2023. The Short Musculoskeletal Function Assessment (SMFA) questionnaire measured patient-reported outcomes, focusing on the bother and mobility indices. Changes in SMFA and EuroQol five-dimension questionnaire (EQ-5D) scores were analyzed from pre-injury (recall) to one year post-injury. Patients' expectations and recovery status were assessed separately.

Results: Among the 8,726 study participants, 27% (n = 2,339) completed the one-year follow-up assessment of patient-reported outcome measures. A significant overall decline in function was observed one year post-injury, indicated by a mean increase of 9.1 (95% CI 8.4 to 9.8) in the bother index and 12.2 (95% CI 11.4 to 13.0) in the mobility index. A minor difference was observed, with females reporting somewhat less successful outcomes than males. A more pronounced functional decline was observed in patients aged ≤ 65 years compared to their older counterparts (those aged > 65 years). Patients receiving operative treatment showed a greater decline in functional outcomes, as measured by SMFA scores, than those managed nonoperatively. More complex fractures, as categorized by the AO/Orthopaedic Trauma Association classification, were associated with worse outcomes. Complete recovery was more probable for patients anticipating such an outcome.

Conclusion: Patella fractures result in a measurable decline in patient-reported functional outcomes one year after injury. Several variables, including fracture morphology, the prescribed treatment, and psychological factors, play a role in the outcome.