精神共病对儿童内侧髌股韧带重建术后疗效的影响
简介
该研究回顾性分析了2000–2020年间美国<18岁因髌股不稳行MPFL重建的患儿，按术前是否存在精神疾病（PMI组 vs 对照组）进行倾向评分匹配。结果显示，PMI组术后1年内膝痛（51.5% vs 41.0%）、阿片类药物使用（42.2% vs 31.4%）、急诊就诊（22.0% vs 4.9%）及物理治疗次数均显著更高。提示术前应关注患儿心理健康，以优…
英文摘要
PURPOSE: To compare postoperative complications, rehabilitation outcomes, and health care utilization in children undergoing primary medial patellofemoral ligament reconstruction for patellofemoral instability with and without a pre-existing mental illness. METHODS: The TriNetX U.S. Collaborative Network was queried to identify patients younger than 18 years old undergoing medial patellofemoral ligament reconstruction for patellar instability in the United States between 2000 and 2020. Patients were then separated into those with a pre-existing mental illness (PMI Group) and those without (Control Group). After propensity score matching for patient demographics, chronic pain, and obesity, postoperative complication rates, rehabilitation outcomes, and health care utilization of both groups were compared across 1 year. RESULTS: After propensity score matching, each group consisted of 223 patients for a total cohort of 446 patients. The PMI Group showed significantly greater rates of postoperative knee pain (51.5% vs 41.0%, P = .004, risk ratios (RR): 1.40), opioid analgesic use (42.2% vs 31.4%, P = .018, RR: 1.34), nonopioid analgesic use (34.5% vs 22.0%, P = .006, RR: 1.27), emergency department visits (22.0% vs 4.9%, P < .001, RR: 4.46), and physical therapy treatment sessions (61.4% vs 51.1%, P = .028, RR: 1.20). CONCLUSIONS: Children with pre-existing mental illness exhibit significantly greater rates of persistent knee pain, higher opioid consumption, and increased health care utilization following medial patellofemoral ligament reconstruction. LEVEL OF EVIDENCE: Level III, retrospective comparative study.