Patient-reported outcomes following patella fractures : a nationwide observational study of 8,726 patients from the Swedish Fracture Register.

Abstract

Patella fractures can greatly impact knee function and quality of life. The primary aim of this study was to assess patient-reported outcomes one-year post-patella fracture. A secondary aim was to evaluate outcome differences based on sex, age, fracture classification, treatment modality, and patients' expectations. This observational study included all patients aged ≥ 18 years at injury with a registered patella fracture in the Swedish Fracture Register between 1 January 2011 and 31 December 2023. The Short Musculoskeletal Function Assessment (SMFA) questionnaire measured patient-reported outcomes, focusing on the bother and mobility indices. Changes in SMFA and EuroQol five-dimension questionnaire (EQ-5D) scores were analyzed from pre-injury (recall) to one year post-injury. Patients' expectations and recovery status were assessed separately. Among the 8,726 study participants, 27% (n = 2,339) completed the one-year follow-up assessment of patient-reported outcome measures. A significant overall decline in function was observed one year post-injury, indicated by a mean increase of 9.1 (95% CI 8.4 to 9.8) in the bother index and 12.2 (95% CI 11.4 to 13.0) in the mobility index. A minor difference was observed, with females reporting somewhat less successful outcomes than males. A more pronounced functional decline was observed in patients aged ≤ 65 years compared to their older counterparts (those aged > 65 years). Patients receiving operative treatment showed a greater decline in functional outcomes, as measured by SMFA scores, than those managed nonoperatively. More complex fractures, as categorized by the AO/Orthopaedic Trauma Association classification, were associated with worse outcomes. Complete recovery was more probable for patients anticipating such an outcome. Patella fractures result in a measurable decline in patient-reported functional outcomes one year after injury. Several variables, including fracture morphology, the prescribed treatment, and psychological factors, play a role in the outcome.