Age at surgery is correlated with pain scores following trochlear osteotomy in lateral patellar instability: a cross-sectional study of 113 cases

Abstract

Background A trochlear osteotomy aims to restore patellar stability in patients with recurrent patellar instability and trochlear dysplasia. The age of patients at time of surgery could be a relevant factor which influences outcome. We hypothesized that lower age at time of surgery is associated with better patient-reported outcomes. Methods A retrospective study was conducted on patients with patellar instability and trochlear dysplasia. Patients were contacted by phone for informed consent and were then asked to complete online patient-reported outcome measurements (PROMs). The PROMs consisted of the Kujala Knee Score (KKS) (Kujala et al., Arthroscopy 9(2):159-63, 1993; Kievit et al. Knee Surg Sports Traumatol Arthrosc. 21(11):2647-53, 2013), the Short Form 36-item health survey (SF-36v1) (Ware, Med Care 73-83, 1992; Aaronson et al., J Clin Epidemiol. 51(11):1055-68, 1998), and visual analog scale (VAS) scoring pain, instability, disability, and satisfaction on a 0–100 scale. Multivariable linear regression models were used to study the effect of age on the PROM scores. Results For this study, 125 surgical procedures in 113 patients were included. Mean VAS pain at rest was 19 and at activity 38; mean Kujala score was 73. Multivariable regression analysis revealed that age at the time of surgery was correlated with VAS pain at rest, with a 0.95 increase of VAS score (scale 0–100) for every year of age. Recurrence of instability was observed in 13 (10%) knees. Conclusion In this cross-sectional study, pain scores of 113 patients who have undergone a lateral facet elevating trochlear osteotomy for patellar instability were reported. Age at time of surgery was correlated with an increased pain score at rest with an average of 9.5 points (scale 0–100) for every 10 years of age. Age at time of surgery was not correlated with overall satisfaction.

Preoperative serum calcium could be a prognostic factor for surgical treatment of recurrent patellar dislocation: a retrospective study

“…Additionally, in the present study, an older age was associated with a poor outcome in most functional scores and acted together with calcium in influencing postoperative Kujala and KOOS pain score. In line with the current study, Sambeeck et al [ 36 ] indicated that age was correlated with an increased pain score at rest. Ling et al [ 6 ] noted age as a variable of biggest relative importance in a multivariable model predicting for a recurrent dislocation.…”

Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction

“…Postoperative outcomes included reoperations, recurrent patellar instability, 10-point Visual Analog Scale (VAS) knee pain at rest, 10-point VAS knee pain during sports/physical activity, 100-point VAS satisfaction with the index procedure [28][29][30], Kujala Anterior Knee score, MPFL-Return to Sport after Injury (MPFL-RSI) score, return to sport, and return to work. For the MPFL-RSI instrument, a score > 56 was considered a passing score indicating psychological readiness to return to sport [10].…”