Klinisk outcome hos patienter med patellainstabilitet, som er behandlet med Elmslie-Trillat operation.

Abstract

Abstract: Baggrund: Der findes en række forskellige operative teknikker for at modvirke patellaluxation. Elmslie-Trillat-operationen er en af de metoder, som tidligere har været anvendt til at stabilisere patella ved at korrigere den mekaniske akse. Der mangler dog viden om hvordan det går patienterne på længere sigt. Formålet med follow-up studiet er at undersøge funktionsniveau og tilfredshed hos patienterne efter Elmslie-Trillat-operation. Metode: 100 patienter blev Elmslie-Trillat-opereret på Aalborg Universitets Hospital i perioden 2000-2012. Dataindsamling ved systematisk gennemgang af samtlige journaler med operationskoderne KNGE09, KNLG89, KNGH72, KNGK79 og KNGK59. 27 patienter deltog i follow-up i 2015, hvor der blev udført fysisk undersøgelse og spørgeskemabesvarelse. Anvendte score-systemer var: Kujala, IKCD subjektiv, IKCD objektiv, Tegner, Lysholm, SANE. Resultater: 27 patienter deltog i follow-up; 20 kvinder og 7 mænd. 15 venstreknæ og 12 højreknæ. Gennemsnitsalder på operationstidspunktet var 20,2 år og gennemsnitsalder ved follow-up var 29,9 år. Kujala-scoren viste ”excellent” eller ”good” resultat hos 18,5%, Lysholm-scoren viste ”excellent” eller ”good” resultat hos 22,2%. IKDC-gennemsnits-scoren var 54,4. Tegner-scoren var 6,34 før operationen og 8,04 efter operationen, dvs. 1,70 point højere, svarende til et forværret funktionsniveau. SANE-gennemsnits-score var på 6,33. 74,1% havde en tilfredshedsscore over 5 og ville gerne gennemgå samme operation igen. 37,0% havde oplevet reluxation postoperativt. Q-vinklen blev gennemsnitligt ændret til 9,15 grader efter operationen Konklusion: Elmslie-Trillat-operationen giver et tilfredsstillende resultat hvad angår patienttilfredshed. Men hvad angår postoperativt aktivitets- og funktionsniveau giver operationen utilfredsstillende resultater. Sammenlignet med andre studier, var det kliniske outcome i dette studie dårligere.

Engelsk Resumé: Background: There is a wide range of different techniques in the treatment of patella luxation. The Elmslie-Trillat procedure is one of the methods, which have earlier been used to stabilize the patella by correcting the mechanical axis. There is however, a lack of knowledge in how this works for patients in the long run. The purpose of this follow up study is to investigate the level of functionality and satisfaction among patients after the Elmslie-Trillat-procedure. Method: 100 patients were treated with the Elmslie-Trillat procedure at Aalborg University Hospital in the period 2000 to 2012. Data retrieval by systematically going through all charts with the procedure codes KNGE09, KNLG89, KNGH72, KNGK79 and KNGK59. 27 patients were present at follow up in 2015, where physical examination was performed and questionnaires were answered. The applied score-systems were: Kujala, IKCD subjective, IKCD objective, Tegner, Lysholm, SANE. Results: 27 patients were present at the time of follow up; 20 females and 7 males. 15 left knees and 12 right knees. Average age at the time of the procedure was 20,2 years, and average age at follow up was 29,9 years. The Kujala-score showed “excellent” or “good” results with 18,5% of the patients, The Lysholm-score showed “excellent” or “good” results with 22,2% of the patients. The IKDC-average-score was 54,4. The Tegner-score was 6,34 before the procedure and 8,04 after the procedure, hereby 1,70 points higher, meaning a reduced level of function. The SANE-average-score was 6,23. 74,1% had a satisfaction-score above 5 and would go through with the same procedure again. 37,0% had experienced reluxation by the time of the follow up. On average the Q-angle was changed to 9,15 degrees after the procedure. Conclusion: The Elmslie-Trillat procedure gives a satisfying result, according to the satisfaction level of the patients. Functionality of the knee after the procedure was not satisfying. Compared to other studies, the clinical outcome was worse.

A master thesis from Aalborg University

Klinisk outcome hos patienter med patellainstabilitet, som er behandlet med Elmslie-Trillat operation.

[Midterm clinical outcome for Patients with Patellar Instability treated with Elmslie-Trillat Procedure.]