Abstract：
UNASSIGNED: It remains unclear which subset of patients with recurrent patellofemoral instability would benefit from a concomitant bony realignment procedure in addition to a medial patellofemoral ligament (MPFL) reconstruction.
UNASSIGNED: To provide midterm results for patients who underwent an isolated MPFL reconstruction as part of an ongoing prospective trial.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: Patients with recurrent patellar instability were prospectively enrolled in an institutional registry beginning in March 2014. Exclusion criteria included history of a previous surgery for patellar instability, an off-loadable (inferior/lateral) chondral defect, anterior knee pain ≥50% of their chief complaint, and a \"jumping J\" sign. All patients underwent primary, unilateral, isolated MPFL reconstruction regardless of their bony anatomic characteristics. Patient-reported outcome measures (PROMs), episodes of recurrent instability, and ability to return to sport were obtained annually. Radiographic measurements of baseline radiographs and MRI were obtained at baseline.
UNASSIGNED: A total of 138 patients underwent isolated MPFL reconstruction between March 2014 and December 2019. The mean radiographic measurements were tibial tubercle-trochlear groove, 15.1 ± 4.9 mm; Caton-Deschamps index, 1.14 ± 0.16; patellar trochlear index, 46.9% ± 15.1%; trochlear depth index, 2.5 ± 1.2 mm; tibial tubercle to lateral trochlear ridge, -8.4 ± 5.7 mm; and patellar tendon to lateral trochlear ridge, 5.7 ± 6.2 mm. Trochlear dysplasia, defined as a trochlear depth index <3 mm, was present in 79/125 (63%) patients. A total of 50 patients reached ≥5 years, of whom 40 (80%) completed follow-up PROMs. A total of 119 patients reached ≥2 years, of whom 89 (75%) completed follow-up PROMs. Six patients (5%) reported recurrent instability with a mean time of 2.97 years after surgery. All PROMs improved over time except for the Pediatric Functional Activity Brief Scale (Pedi-FABS), which had no change. At 2 years, the mean changes from baseline for Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale (QOL), Pedi-FABS, International Knee Documentation Committee (IKDC) score, KOOS Physical Function Short Form (PS), and Kujala score were 42.1, 0.6, 35.1, -23.5, and 32.3, respectively. All changes had P values <.001 except for Pedi-FABS, which showed no change and had P > .999. At 5 years, the mean changes from baseline for KOOS-QOL, Pedi-FABS, IKDC, KOOS-PS, and Kujala score were 42.6, -2.8, 32.6, -21.5, and 31.6, respectively. All changes had P values <.001 except for Pedi-FABS, which showed no change and had P > .453. In total, 89% of patients returned to sport with a mean of 9.1 months.
UNASSIGNED: Midterm outcomes for patients who underwent isolated MPFL reconstruction were favorable and were maintained at 5 years. Outcomes for the expanded cohort of patients with a minimum 2-year follow-up support previously published results.
UNASSIGNED: To provide midterm results for patients who underwent an isolated MPFL reconstruction as part of an ongoing prospective trial.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: Patients with recurrent patellar instability were prospectively enrolled in an institutional registry beginning in March 2014. Exclusion criteria included history of a previous surgery for patellar instability, an off-loadable (inferior/lateral) chondral defect, anterior knee pain ≥50% of their chief complaint, and a \"jumping J\" sign. All patients underwent primary, unilateral, isolated MPFL reconstruction regardless of their bony anatomic characteristics. Patient-reported outcome measures (PROMs), episodes of recurrent instability, and ability to return to sport were obtained annually. Radiographic measurements of baseline radiographs and MRI were obtained at baseline.
UNASSIGNED: A total of 138 patients underwent isolated MPFL reconstruction between March 2014 and December 2019. The mean radiographic measurements were tibial tubercle-trochlear groove, 15.1 ± 4.9 mm; Caton-Deschamps index, 1.14 ± 0.16; patellar trochlear index, 46.9% ± 15.1%; trochlear depth index, 2.5 ± 1.2 mm; tibial tubercle to lateral trochlear ridge, -8.4 ± 5.7 mm; and patellar tendon to lateral trochlear ridge, 5.7 ± 6.2 mm. Trochlear dysplasia, defined as a trochlear depth index <3 mm, was present in 79/125 (63%) patients. A total of 50 patients reached ≥5 years, of whom 40 (80%) completed follow-up PROMs. A total of 119 patients reached ≥2 years, of whom 89 (75%) completed follow-up PROMs. Six patients (5%) reported recurrent instability with a mean time of 2.97 years after surgery. All PROMs improved over time except for the Pediatric Functional Activity Brief Scale (Pedi-FABS), which had no change. At 2 years, the mean changes from baseline for Knee injury and Osteoarthritis Outcome Score (KOOS) Quality of Life subscale (QOL), Pedi-FABS, International Knee Documentation Committee (IKDC) score, KOOS Physical Function Short Form (PS), and Kujala score were 42.1, 0.6, 35.1, -23.5, and 32.3, respectively. All changes had P values <.001 except for Pedi-FABS, which showed no change and had P > .999. At 5 years, the mean changes from baseline for KOOS-QOL, Pedi-FABS, IKDC, KOOS-PS, and Kujala score were 42.6, -2.8, 32.6, -21.5, and 31.6, respectively. All changes had P values <.001 except for Pedi-FABS, which showed no change and had P > .453. In total, 89% of patients returned to sport with a mean of 9.1 months.
UNASSIGNED: Midterm outcomes for patients who underwent isolated MPFL reconstruction were favorable and were maintained at 5 years. Outcomes for the expanded cohort of patients with a minimum 2-year follow-up support previously published results.
摘要：
■除内侧髌股韧带（MPFL）重建外，还不清楚哪些复发性髌股不稳定的患者亚组将从伴随的骨重新对准手术中受益。
■为接受孤立MPFL重建的患者提供中期结果，作为正在进行的前瞻性试验的一部分。
■案例系列；证据级别，4.
■复发性髌骨不稳定的患者于2014年3月开始前瞻性纳入机构注册。排除标准包括既往髌骨不稳定手术史，可卸载（下/侧）软骨缺损，膝前疼痛≥主诉的50%，还有一个“跳跃的J”标志。所有患者都接受了原发性，单边,孤立的MPFL重建，无论其骨解剖特征如何。患者报告结果测量(PROM)，反复发作的不稳定，每年都能获得重返体育运动的能力。基线X线照片和MRI的射线照相测量在基线获得。
■在2014年3月至2019年12月期间，共有138例患者接受了孤立的MPFL重建。平均影像学测量为胫骨结节-滑车沟，15.1±4.9毫米；卡顿-德尚指数，1.14±0.16；髌骨滑车指数，46.9%±15.1%;滑车深度指数,2.5±1.2mm;胫骨结节至外侧滑车脊;-8.4±5.7mm；髌腱至外侧滑车脊，5.7±6.2mm。滑车发育不良,定义为滑车深度指数<3mm，存在于79/125（63％）患者中。共有50名患者达到≥5年，其中40（80％）完成了随访PROM。共有119名患者达到≥2年，其中89例（75％）完成了PROM的随访。6例（5％）患者报告了复发性不稳定性，平均手术时间为手术后2.97年。随着时间的推移，除了儿科功能活动简要量表（Pedi-FABS）外，所有PROM都有所改善，没有变化。在2年,膝关节损伤和骨关节炎结果评分（KOOS）生活质量分量表（QOL）的基线平均变化，Pedi-FABS,国际膝关节文献委员会（IKDC）评分，KOOS物理函数简式(PS)，Kujala评分分别为42.1、0.6、35.1、-23.5和32.3。除Pedi-FABS外，所有变化的P值<.001，没有变化，P>.999。在5年,KOOS-QOL相对于基线的平均变化，Pedi-FABS,IKDC,KOOS-PS,Kujala评分分别为42.6、-2.8、32.6、-21.5和31.6。除Pedi-FABS外，所有变化的P值<.001，没有变化，P>.453。总的来说,89％的患者恢复运动，平均9.1个月。
■接受孤立性MPFL重建的患者的中期结局是有利的，并在5年后维持。具有至少2年随访支持先前发表的结果的扩大的患者队列的结果。
■为接受孤立MPFL重建的患者提供中期结果，作为正在进行的前瞻性试验的一部分。
■案例系列；证据级别，4.
■复发性髌骨不稳定的患者于2014年3月开始前瞻性纳入机构注册。排除标准包括既往髌骨不稳定手术史，可卸载（下/侧）软骨缺损，膝前疼痛≥主诉的50%，还有一个“跳跃的J”标志。所有患者都接受了原发性，单边,孤立的MPFL重建，无论其骨解剖特征如何。患者报告结果测量(PROM)，反复发作的不稳定，每年都能获得重返体育运动的能力。基线X线照片和MRI的射线照相测量在基线获得。
■在2014年3月至2019年12月期间，共有138例患者接受了孤立的MPFL重建。平均影像学测量为胫骨结节-滑车沟，15.1±4.9毫米；卡顿-德尚指数，1.14±0.16；髌骨滑车指数，46.9%±15.1%;滑车深度指数,2.5±1.2mm;胫骨结节至外侧滑车脊;-8.4±5.7mm；髌腱至外侧滑车脊，5.7±6.2mm。滑车发育不良,定义为滑车深度指数<3mm，存在于79/125（63％）患者中。共有50名患者达到≥5年，其中40（80％）完成了随访PROM。共有119名患者达到≥2年，其中89例（75％）完成了PROM的随访。6例（5％）患者报告了复发性不稳定性，平均手术时间为手术后2.97年。随着时间的推移，除了儿科功能活动简要量表（Pedi-FABS）外，所有PROM都有所改善，没有变化。在2年,膝关节损伤和骨关节炎结果评分（KOOS）生活质量分量表（QOL）的基线平均变化，Pedi-FABS,国际膝关节文献委员会（IKDC）评分，KOOS物理函数简式(PS)，Kujala评分分别为42.1、0.6、35.1、-23.5和32.3。除Pedi-FABS外，所有变化的P值<.001，没有变化，P>.999。在5年,KOOS-QOL相对于基线的平均变化，Pedi-FABS,IKDC,KOOS-PS,Kujala评分分别为42.6、-2.8、32.6、-21.5和31.6。除Pedi-FABS外，所有变化的P值<.001，没有变化，P>.453。总的来说,89％的患者恢复运动，平均9.1个月。
■接受孤立性MPFL重建的患者的中期结局是有利的，并在5年后维持。具有至少2年随访支持先前发表的结果的扩大的患者队列的结果。
