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Published on: May 21, 2013
Isolated Patellar Chondromalacia Treated With Arthroscopic Chondroplasty Provides Significant Early Improvements in
Nathan Sherman1,2, Kelan Queenan3, Jillian L Mazzocca1
1Department of Orthopaedic Surgery Mass General Brigham Boston Massachusetts U.S.A.
Purpose:
To report 1-year patient-reported outcomes in retrospectively reviewed patients who underwent isolated arthroscopic patellar chondroplasty and determine preoperative risk factors for not reaching the Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain subscore patient acceptable symptom state (PASS) threshold.
Methods:
From a surgeon's outcomes registry, patients who underwent isolated arthroscopic patellar chondroplasty were identified. Patients were asked to complete the KOOS, Single Assessment Numerical Evaluation, Pain Visual Analog Scale, Marx Activity Rating Scale, and Veterans RAND 12-Item Health Survey preoperatively and at 3, 6, and 12 months postoperatively. Changes in patient-reported outcomes over time were assessed with repeated-measures analysis of variance. Additionally, we quantified the number of patients who met PASS thresholds for KOOS subscales 12 months postoperatively. To determine if patient demographic or surgical variables were predictive of a patient achieving KOOS Pain PASS, a binary logistic regression was done.
Results:
Thirty-nine patients with complete pre- and postoperative data were identified and included in the analyses (35 women/4 men, mean age = 31.4 years, mean body mass index = 26.5). Except for Veterans RAND 12-Item Health Survey Mental Component Scores (P = .33) and Marx Activity Rating Scale scores (P = .11), all other outcome measures significantly improved from baseline to 3 months (P < .001), and results were maintained at 12 months. Most patients achieved KOOS PASS threshold scores at 12 months (Pain: 32/39 patients [82.1%], Symptoms: 24/39 [61.5%], Activities of Daily Living: 30/39 [76.9%], Sport and Recreation Function: 35/39 [89.7%], Knee-Related Quality of Life: 29/39 [74.4%]). There were no significant preoperative predictive factors for reaching a KOOS Pain PASS threshold.
Conclusions:
Isolated patellar chondroplasty provided significant early improvements in patient-reported outcomes as early as 3 months after surgery, with the majority maintaining PASS at 12 months.
Level Of Evidence:
Level IV, retrospective case series.
