M. Kolar (Ljubljana, SI)
University Medical Centre Ljubljana Orthopaedic SurgeryPresenter Of 2 Presentations
P193 - Cartilage Lesions in Patellofemoral Instability: A Significant Source of Patients’ Pain and Disability
Abstract
Purpose
Cartilage injuries occur in more than 70% of patellar dislocations, and may cause an additional knee disability. The aim of the study was to compare subjective knee status, quality of life and activity levels in patients with isolated patellofemoral instability (PFI), in PFI patients with an additional patellofemoral cartilage lesion (PFI-CL), and in patients with isolated cartilage lesions on the femoral condyles (FC-CL).
Methods and Materials
The study group comprised of 25 isolated PFI, 10 PFI-CL, and 12 FC-CL patients, who were scheduled for a knee reconstructive procedure. Only patients with mild cartilage involvement (ICRS grade 1) were enrolled in PFI subgroup, while patients in PFI-CL and FC-CL suffered from an isolated ICRS grade 3 or 4 lesion. Presence of mild radiographic OA (Kellgren-Lawrence grades 1-2) was allowed in all subgroups. The evaluation was performed by using subjective outcome measures (PROMs) for knee specific function (KOOS), general quality of life (EQ-5D-3L, EQ-VAS), and patients’ activity levels (Tegner activity scale – TAS). One-way ANOVA with Tukey post hoc test was used to identify significant differences in PROMs between the subgroups.
Results
The subjective knee status was the most profoundly affected in PFI-CL, followed by FC-CL, and PFI. PFI-CL and FC-CL groups had significantly more pain (KOOS Pain (PFI-CL, FC-CL): p < 0.001, p < 0.001) and were less daily active (KOOS ADL (PFI-CL, FC-CL): p = 0.026, p = 0.027) compared to PFI patients. Furthermore, PFI-CL patients had significantly lower knee related quality of life (KOOS QoL: p = 0.038) and were less sports active (KOOS Sport: p = 0.037) compared to PFI group.
Conclusion
Isolated cartilage lesions on patellofemoral or condylar articular areas of the knee do have a profound impact on patients’ perceived knee function and related quality of life. In patients with PFI, an additional isolated cartilage lesion significantly deteriorates the subjective knee status.
P194 - Subjective Joint Status and the Related Quality of Life in Patients with Cartilage Lesions of the Knee. A Preliminary Report
Abstract
Purpose
To analyse subjective knee status, quality of life, and activity level for patients with cartilage lesions of the knee (CL-K) scheduled for cartilage repair surgery.
Methods and Materials
Sixty-three patients, scheduled for surgical repair of CL-K (ICRS grades 3-4), were evaluated preoperatively with standard subjective outcome measures (PROMs) for their knee specific function (KOOS subscales), general quality of life (EQ-5D-3L, EQ-VAS) and activity levels (Tegner activity scale – TAS). The patients’ (age; gender; BMI; surgical history; symptoms duration), knees’ (concomitant pathologies: patellofemoral instability, meniscus injury, cruciate ligament tear; radiographic OA status by Kellgren-Lawrence), and lesions’ (size; location) characteristics were tested as possible predicting factors against PROMs above with a linear regression models. PROMs levels were additionally compared to the general population norms.
Results
We could not identify significant correlations of any predicting factor for EQ-VAS and TAS, but certain factors were correlated with KOOS subscales and EQ-5D-3L. Females and patients with previous surgeries had significantly lower KOOS Symptoms. KOOS Pain was lower in older patients, higher OA and previous knee surgeries. KOOS Sports was decreased in patients with previous knee surgeries. KOOS ADL and EQ-5D-3L were negatively correlated with increasing age. KOOS QoL had significantly higher values in younger patients without previous surgeries. In comparison to the general population, KOOS subscales were reduced from 20% (KOOS Symptoms) to 66% (KOOS QoL), while EQ-5D-3L was reduced on average for 31%, and average TAS for 46%.
Conclusion
Based on this preliminary data, patients with CL-K scheduled for surgical intervention report significantly lower joint-specific function, quality of life, and activity levels. Older or female patients, especially the ones with higher radiographic OA grades and the ones with previous surgical interventions, seem to be affected the most. Further analysis, with improved statistical power, is undergoing to identify other possible predicting factors and to individualize CL-K treatment protocols.
Presenter Of 2 Presentations
P193 - Cartilage Lesions in Patellofemoral Instability: A Significant Source of Patients’ Pain and Disability
Abstract
Purpose
Cartilage injuries occur in more than 70% of patellar dislocations, and may cause an additional knee disability. The aim of the study was to compare subjective knee status, quality of life and activity levels in patients with isolated patellofemoral instability (PFI), in PFI patients with an additional patellofemoral cartilage lesion (PFI-CL), and in patients with isolated cartilage lesions on the femoral condyles (FC-CL).
Methods and Materials
The study group comprised of 25 isolated PFI, 10 PFI-CL, and 12 FC-CL patients, who were scheduled for a knee reconstructive procedure. Only patients with mild cartilage involvement (ICRS grade 1) were enrolled in PFI subgroup, while patients in PFI-CL and FC-CL suffered from an isolated ICRS grade 3 or 4 lesion. Presence of mild radiographic OA (Kellgren-Lawrence grades 1-2) was allowed in all subgroups. The evaluation was performed by using subjective outcome measures (PROMs) for knee specific function (KOOS), general quality of life (EQ-5D-3L, EQ-VAS), and patients’ activity levels (Tegner activity scale – TAS). One-way ANOVA with Tukey post hoc test was used to identify significant differences in PROMs between the subgroups.
Results
The subjective knee status was the most profoundly affected in PFI-CL, followed by FC-CL, and PFI. PFI-CL and FC-CL groups had significantly more pain (KOOS Pain (PFI-CL, FC-CL): p < 0.001, p < 0.001) and were less daily active (KOOS ADL (PFI-CL, FC-CL): p = 0.026, p = 0.027) compared to PFI patients. Furthermore, PFI-CL patients had significantly lower knee related quality of life (KOOS QoL: p = 0.038) and were less sports active (KOOS Sport: p = 0.037) compared to PFI group.
Conclusion
Isolated cartilage lesions on patellofemoral or condylar articular areas of the knee do have a profound impact on patients’ perceived knee function and related quality of life. In patients with PFI, an additional isolated cartilage lesion significantly deteriorates the subjective knee status.
P194 - Subjective Joint Status and the Related Quality of Life in Patients with Cartilage Lesions of the Knee. A Preliminary Report
Abstract
Purpose
To analyse subjective knee status, quality of life, and activity level for patients with cartilage lesions of the knee (CL-K) scheduled for cartilage repair surgery.
Methods and Materials
Sixty-three patients, scheduled for surgical repair of CL-K (ICRS grades 3-4), were evaluated preoperatively with standard subjective outcome measures (PROMs) for their knee specific function (KOOS subscales), general quality of life (EQ-5D-3L, EQ-VAS) and activity levels (Tegner activity scale – TAS). The patients’ (age; gender; BMI; surgical history; symptoms duration), knees’ (concomitant pathologies: patellofemoral instability, meniscus injury, cruciate ligament tear; radiographic OA status by Kellgren-Lawrence), and lesions’ (size; location) characteristics were tested as possible predicting factors against PROMs above with a linear regression models. PROMs levels were additionally compared to the general population norms.
Results
We could not identify significant correlations of any predicting factor for EQ-VAS and TAS, but certain factors were correlated with KOOS subscales and EQ-5D-3L. Females and patients with previous surgeries had significantly lower KOOS Symptoms. KOOS Pain was lower in older patients, higher OA and previous knee surgeries. KOOS Sports was decreased in patients with previous knee surgeries. KOOS ADL and EQ-5D-3L were negatively correlated with increasing age. KOOS QoL had significantly higher values in younger patients without previous surgeries. In comparison to the general population, KOOS subscales were reduced from 20% (KOOS Symptoms) to 66% (KOOS QoL), while EQ-5D-3L was reduced on average for 31%, and average TAS for 46%.
Conclusion
Based on this preliminary data, patients with CL-K scheduled for surgical intervention report significantly lower joint-specific function, quality of life, and activity levels. Older or female patients, especially the ones with higher radiographic OA grades and the ones with previous surgical interventions, seem to be affected the most. Further analysis, with improved statistical power, is undergoing to identify other possible predicting factors and to individualize CL-K treatment protocols.