Abstract：
UNASSIGNED: Patellofemoral instability is associated with chondral injuries to the patella, trochlea, and lateral femoral condyle. Although studies have demonstrated an association between patellar dislocations and chondral injuries, the influence of the number of dislocations on chondrosis is not established.
UNASSIGNED: To elucidate the precise association between the number of patellar dislocation events and the severity of chondral injuries in a multicenter cohort study at the time of patellar stabilization procedures.
UNASSIGNED: Cross-sectional study; Level of evidence, 2.
UNASSIGNED: A prospective multicenter cohort study (JUPITER [Justifying Patellar Instability Treatment by Early Results]) database was queried for cases of primary patellofemoral instability procedures from December 2016 to September 2022. Cartilage lesions were classified using the International Cartilage Repair Society (ICRS) classification system during an arthroscopic or open evaluation (direct visualization), with grades 2 to 4 considered abnormal. The number of dislocations was categorized as 1, 2-5, and >5. Categorical variables were compared with the chi-square test, and binary logistic regression was performed to identify predictors of the presence of chondral lesions.
UNASSIGNED: A total of 938 knees (mean age, 16.2 ± 3.8 years; 61.4% female) were included, with 580 (61.8%) demonstrating a chondral injury. The most affected region was the patella (n = 498 [53.1%]), followed by the lateral femoral condyle (n = 117 [12.5%]) and trochlea (n = 109 [11.6%]). There were no differences in the presence (P = .17) or grade (P = .63) of patellar lesions by the number of dislocations. Patients with >5 dislocations more frequently had trochlear chondral lesions (19.8%) compared with those with fewer dislocations (1, 7.6%; 2-5, 11.0%; P < .001). More dislocations were also associated with a higher proportion of ICRS grade 2 to 4 trochlear lesions (>5, 15.3%; 2-5, 10.0%; 1, 6.9%; P = .015). Combined patellar and trochlear lesions were also more common in those with >5 dislocations (P = .001). In multivariable regression, >5 dislocations was the only variable predictive of a trochlear lesion (odds ratio, 3.03 [95% CI, 1.65-5.58]; P < .001).
UNASSIGNED: This large prospective cohort study demonstrated that recurrent patellar dislocations can lead to more severe chondral damage in specific locations in the knee. More than 5 dislocations was associated with a >3-fold increase in the incidence and severity of trochlear chondral injuries. There were no differences in the presence or grade of patellar lesions by the number of dislocations. These findings should caution surgeons regarding prolonged nonoperative treatment.
UNASSIGNED: To elucidate the precise association between the number of patellar dislocation events and the severity of chondral injuries in a multicenter cohort study at the time of patellar stabilization procedures.
UNASSIGNED: Cross-sectional study; Level of evidence, 2.
UNASSIGNED: A prospective multicenter cohort study (JUPITER [Justifying Patellar Instability Treatment by Early Results]) database was queried for cases of primary patellofemoral instability procedures from December 2016 to September 2022. Cartilage lesions were classified using the International Cartilage Repair Society (ICRS) classification system during an arthroscopic or open evaluation (direct visualization), with grades 2 to 4 considered abnormal. The number of dislocations was categorized as 1, 2-5, and >5. Categorical variables were compared with the chi-square test, and binary logistic regression was performed to identify predictors of the presence of chondral lesions.
UNASSIGNED: A total of 938 knees (mean age, 16.2 ± 3.8 years; 61.4% female) were included, with 580 (61.8%) demonstrating a chondral injury. The most affected region was the patella (n = 498 [53.1%]), followed by the lateral femoral condyle (n = 117 [12.5%]) and trochlea (n = 109 [11.6%]). There were no differences in the presence (P = .17) or grade (P = .63) of patellar lesions by the number of dislocations. Patients with >5 dislocations more frequently had trochlear chondral lesions (19.8%) compared with those with fewer dislocations (1, 7.6%; 2-5, 11.0%; P < .001). More dislocations were also associated with a higher proportion of ICRS grade 2 to 4 trochlear lesions (>5, 15.3%; 2-5, 10.0%; 1, 6.9%; P = .015). Combined patellar and trochlear lesions were also more common in those with >5 dislocations (P = .001). In multivariable regression, >5 dislocations was the only variable predictive of a trochlear lesion (odds ratio, 3.03 [95% CI, 1.65-5.58]; P < .001).
UNASSIGNED: This large prospective cohort study demonstrated that recurrent patellar dislocations can lead to more severe chondral damage in specific locations in the knee. More than 5 dislocations was associated with a >3-fold increase in the incidence and severity of trochlear chondral injuries. There were no differences in the presence or grade of patellar lesions by the number of dislocations. These findings should caution surgeons regarding prolonged nonoperative treatment.
摘要：
■髌股不稳定与髌骨软骨损伤有关，滑车,和股骨外侧髁。尽管研究表明髌骨脱位与软骨损伤之间存在关联，脱位数量对软骨病的影响尚未确定。
■为了阐明髌骨稳定手术时的多中心队列研究中髌骨脱位事件的数量与软骨损伤的严重程度之间的精确关联。
■横断面研究；证据水平，2.
一项前瞻性多中心队列研究（JUPITER[通过早期结果证明髌骨不稳定治疗]）数据库查询了2016年12月至2022年9月原发性髌股不稳定手术的病例。在关节镜或开放评估（直接可视化）期间，使用国际软骨修复协会（ICRS）分类系统对软骨病变进行分类。2到4年级被认为是异常的。脱位的数量分类为1、2-5和>5。分类变量用卡方检验进行比较，并进行二元逻辑回归以确定软骨损伤存在的预测因子。
■总共938个膝盖（平均年龄，16.2±3.8岁；61.4%的女性）被包括在内，580（61.8％）显示软骨损伤。影响最大的区域是髌骨(n=498[53.1%]),其次是股骨外侧髁（n=117[12.5%]）和滑车（n=109[11.6%]）。根据脱位的数量，髌骨病变的存在（P=0.17）或等级（P=0.63）没有差异。>5例脱位患者滑车软骨损伤发生率较高（19.8%），而脱位发生率较低（1，7.6%；2-5，11.0%；P<.001）。更多的脱位也与更高比例的ICRS2至4级滑车病变相关(>5,15.3%;2-5,10.0%;1,6.9%;P=0.015)。髌骨和滑车联合病变在>5脱位的患者中也更常见(P=.001)。在多变量回归中，>5脱位是滑车病变的唯一预测变量(比值比，3.03[95%CI，1.65-5.58]；P<.001）。
■这项大型前瞻性队列研究表明，复发性髌骨脱位可导致膝关节特定位置更严重的软骨损伤。超过5个脱位与滑车软骨损伤的发生率和严重程度增加>3倍相关。脱位的数量在the骨病变的存在或等级上没有差异。这些发现应提醒外科医生长期非手术治疗。
■为了阐明髌骨稳定手术时的多中心队列研究中髌骨脱位事件的数量与软骨损伤的严重程度之间的精确关联。
■横断面研究；证据水平，2.
一项前瞻性多中心队列研究（JUPITER[通过早期结果证明髌骨不稳定治疗]）数据库查询了2016年12月至2022年9月原发性髌股不稳定手术的病例。在关节镜或开放评估（直接可视化）期间，使用国际软骨修复协会（ICRS）分类系统对软骨病变进行分类。2到4年级被认为是异常的。脱位的数量分类为1、2-5和>5。分类变量用卡方检验进行比较，并进行二元逻辑回归以确定软骨损伤存在的预测因子。
■总共938个膝盖（平均年龄，16.2±3.8岁；61.4%的女性）被包括在内，580（61.8％）显示软骨损伤。影响最大的区域是髌骨(n=498[53.1%]),其次是股骨外侧髁（n=117[12.5%]）和滑车（n=109[11.6%]）。根据脱位的数量，髌骨病变的存在（P=0.17）或等级（P=0.63）没有差异。>5例脱位患者滑车软骨损伤发生率较高（19.8%），而脱位发生率较低（1，7.6%；2-5，11.0%；P<.001）。更多的脱位也与更高比例的ICRS2至4级滑车病变相关(>5,15.3%;2-5,10.0%;1,6.9%;P=0.015)。髌骨和滑车联合病变在>5脱位的患者中也更常见(P=.001)。在多变量回归中，>5脱位是滑车病变的唯一预测变量(比值比，3.03[95%CI，1.65-5.58]；P<.001）。
■这项大型前瞻性队列研究表明，复发性髌骨脱位可导致膝关节特定位置更严重的软骨损伤。超过5个脱位与滑车软骨损伤的发生率和严重程度增加>3倍相关。脱位的数量在the骨病变的存在或等级上没有差异。这些发现应提醒外科医生长期非手术治疗。
