Returning to pre-injury level of sports before 9 months after medial patellofemoral ligament reconstruction increases the incidence of anterior knee pain in young patients

IF 5 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-08-09 DOI:10.1002/ksa.12411

Chenyue Xu, Yuchen Zhao, Zhengyi Ni, Kehan Li, Huijun Kang, Fei Wang

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Abstract

Purpose

This study aimed to identify the risk factors for anterior knee pain (AKP) after medial patellofemoral ligament reconstruction (MPFLR).

Methods

Patients aged 15–35 years who underwent isolated MPFLR between 2012 and 2022 were included in the study. These patients were divided into two groups (AKP and control group). Patient demographics and preoperative and postoperative clinical outcomes between the two groups were assessed and compared. Univariate logistic regression analysis was performed to explore the potential risk factors associated with postoperative AKP. Subgroup analysis stratified the results based on the time to return to sports (RTS) (>9 and ≤9 months). Furthermore, Spearman correlation analysis was performed to investigate the association between Kujala score and time to RTS.

Results

A total of 206 patients were included (AKP, n = 59; control, n = 147). At the 2-year follow-up, patients with AKP demonstrated a shorter duration in returning to their pre-injury activity level compared to those without AKP (9.0 ± 3.6 vs. 10.3 ± 2.7 months, p < 0.05). RTS earlier than 9 months after MPFLR was the only significant risk factor associated with postoperative AKP (odds ratio, 2.13, 95% confidence interval, 1.03-4.39; p < 0.05). Further subgroup analysis revealed that patient RTS earlier than 9 months exhibited worse patient-reported outcomes in both the total cohort and control group (p < 0.05). Furthermore, among patient RTS within 9 months, a longer recovery duration before RTS strongly correlated with a higher Kujala score (R = 0.670, p < 0.001).

Conclusions

Young patients who RTS at their pre-injury levels before 9 months after MPFLR have a higher incidence of postoperative AKP and poorer functional outcomes compared to those who delay their return. Specifically, within the first 9 months after MPFLR, the earlier the RTS, the more severe the AKP symptoms. Careful consideration of the timing for RTS may help reduce the incidence of postoperative AKP.

Level of Evidence

Level III.

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在髌股内侧韧带重建术后 9 个月之前恢复到受伤前的运动水平，会增加年轻患者膝关节前部疼痛的发生率。

目的：本研究旨在确定髌股内侧韧带重建术（MPFLR）后膝关节前侧疼痛（AKP）的风险因素：研究纳入了 2012 年至 2022 年期间接受孤立 MPFLR 的 15-35 岁患者。这些患者被分为两组（AKP 组和对照组）。对两组患者的人口统计学特征、术前和术后临床结果进行评估和比较。为探究与术后 AKP 相关的潜在风险因素，进行了单变量逻辑回归分析。分组分析根据恢复运动（RTS）的时间（大于 9 个月和小于 9 个月）对结果进行了分层。此外，还进行了斯皮尔曼相关分析，以研究Kujala评分与恢复运动时间之间的关联：共纳入 206 名患者（AKP，59 人；对照组，147 人）。在为期 2 年的随访中，与无 AKP 的患者相比，AKP 患者恢复到受伤前活动水平的时间更短（9.0 ± 3.6 个月 vs. 10.3 ± 2.7 个月，p 结论：KKP 患者恢复到受伤前活动水平的时间更短（9.0 ± 3.6 个月 vs. 10.3 ± 2.7 个月，p）：与延迟恢复的患者相比，在 MPFLR 术后 9 个月前恢复到受伤前水平的年轻患者术后 AKP 的发生率更高，功能预后更差。具体来说，在 MPFLR 术后的前 9 个月内，RTS 越早，AKP 症状越严重。仔细考虑RTS的时机可能有助于降低术后AKP的发生率：证据等级：三级。

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 Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).