Background:

Medial patellofemoral ligament (MPFL) reconstruction is performed to treat recurrent patellar instability. Measurement of joint pain and function at the time of surgery has been demonstrated to be a predictor of the final outcomes in many surgical procedures.

Purpose/Hypothesis:

The purpose of this study was to evaluate the relationship between baseline patient characteristics, mental health, and intraoperative findings and patient-reported knee pain and function at the time of MPFL reconstruction. We hypothesized that patient characteristics and associated pathology would be associated with the degree of pain and dysfunction.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Included were skeletally mature patients who underwent unilateral open MPFL reconstruction between 2015 and 2020 at a single institution. Baseline descriptive information was collected, and the following outcome measures were administered preoperatively: the Veterans RAND 12-Item Health Survey Mental Component Score (VR-12 MCS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain, Physical Function Short Form (PS), and Quality of Life (QoL) subscales. Intraoperative findings were collected in a standardized format. Patient characteristics, preoperative variables, intraoperative findings, and VR-12 MCS were used as risk factors, and multivariate analysis was conducted to assess for relationships with the KOOS subscale scores.

Results:

In total, 201 patients with patella dislocations were included in this analysis. Intraoperatively, 122 patients (60.7%) had either normal cartilage or grade 1 or 2 cartilage injury, 79 patients (39.3%) had grade 3 or 4 cartilage injury, 35 patients (17.4%) had a loose body, and 3 patients (1.49%) had evidence of synovitis. Younger age (P = .012), male sex (P < .001), never having smoked (P = .029), and lower baseline VR-MCS (P < .001) were significantly associated with higher baseline KOOS Pain scores. Older age (P = .035), female sex (P = .003), higher body mass index (P = .005), and lower baseline VR-12 MCS (P < .001) were significantly associated with higher baseline KOOS PS scores. Younger age (P = .003), male sex (P < .001), lower baseline VR-12 MCS (P < .001), and no dysplasia (P = .023) were significantly associated with higher baseline KOOS QoL scores.

Conclusion:

Patient age, sex, and baseline VR-12 MCS were associated with all 3 baseline KOOS subscale scores, whereas intraoperative findings outside of trochlear dysplasia were not associated with any of the KOOS subscale scores.

中文翻译：

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内侧髌股韧带重建前与疼痛和功能相关的因素

背景：

内侧髌股韧带（MPFL）重建用于治疗复发性髌骨不稳定。手术时关节疼痛和功能的测量已被证明是许多外科手术最终结果的预测指标。

目的/假设：

本研究的目的是评估基线患者特征、心理健康和术中发现与 MPFL 重建时患者报告的膝关节疼痛和功能之间的关系。我们假设患者特征和相关病理与疼痛和功能障碍的程度有关。

学习规划：

横断面研究；证据水平，3。

方法：

包括 2015 年至 2020 年间在单一机构接受单侧开放式 MPFL 重建的骨骼成熟患者。收集了基线描述信息，并在术前进行了以下结果测量：退伍军人兰德 12 项健康调查心理成分评分 (VR-12 MCS) 和膝关节损伤和骨关节炎结果评分 (KOOS) 疼痛、身体功能简表 ( PS) 和生活质量 (QoL) 分量表。术中发现以标准化格式收集。患者特征、术前变量、术中发现和 VR-12 MCS 被用作危险因素，并进行多变量分析以评估与 KOOS 子量表评分的关系。

结果：

共有 201 名髌骨脱位患者被纳入该分析。术中，122 例（60.7%）软骨正常或 1 级或 2 级软骨损伤，79 例（39.3%）3 级或 4 级软骨损伤，35 例（17.4%）有游离体，3 例（1.49 %) 有滑膜炎的证据。年龄较小 ( P = .012)、男性 ( P < .001)、从未吸烟 ( P = .029) 和较低的基线 VR-MCS ( P < .001) 与较高的基线 KOOS 疼痛评分显着相关。年龄较大 ( P = .035)、女性 ( P = .003)、体重指数较高 ( P = .005) 和基线 VR-12 MCS ( P< .001) 与较高的基线 KOOS PS 分数显着相关。年龄较小 ( P = .003)、男性 ( P < .001)、基线 VR-12 MCS ( P < .001) 和无发育异常 ( P = .023) 与较高的基线 KOOS QoL 评分显着相关。

结论：

患者年龄、性别和基线 VR-12 MCS 与所有 3 个基线 KOOS 子量表评分相关，而滑车发育不良以外的术中发现与任何 KOOS 子量表评分均不相关。