Altered long-term health-related quality of life in patients following patella fractures: a long-term follow-up study of 49 patients
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The primary aim was to investigate the health-related quality of life (HRQOL) in patients treated for a patella fracture. The explorative aim was to report the associations between HRQOL, knee osteoarthritis, muscle strength and gait function.
The study design was a cohort study. Patients who were treated for patella fractures at Aalborg University Hospital, Denmark between January 2006 and December 2009 were identified. Patients between the age of 18 and 80 were included. The main outcome was assessed by the EQ5D–5L questionnaire. Classifications by Sperner and Kellgren/Lawrence were applied to evaluate osteoarthritis. Moreover, functional outcomes were evaluated by: KOOS, muscle strength and gait analysis.
Forty-nine patients were included with a mean follow-up time of 8.5 years. The mean age was 53.9 years. The mean EQ5D–5L index value was 0.741, and was significantly worse compared to a reference population. X-rays taken at the time of diagnosis and the time of follow-up showed progression towards a higher degree of osteoarthritis in the injured knee for both the patellofemoral and tibiofemoral joints. Patients demonstrated significantly lower knee extension strength in the injured leg compared to the non-injured leg (P = 0.011). No significant difference in gait speed and cadence were observed compared to the reference population. Knee osteoarthritis, muscle strength and gait patterns were not associated with HRQOL (R < 0.35).
At 8.5 years following a patella fracture, HRQOL was significantly worse compared to an age-matched reference population.
KeywordsPatella fracture Long-term outcome HRQOL Functional outcome
Compliance with ethical standards
Conflict of interest
The authors have no conflicts of interest to report. The authors did not receive benefits or grants in any form from a commercial part related directly or indirectly to the subject of this article.
This study was conducted in accordance with the ethical standards of the responsible committee and with the ethical principles of the 1975 Declaration of Helsinki. The Danish Data Protection Agency (Journal no. 2008-58-0028 ID 2016-115) and the Committee for Science Ethics of Northern Denmark (Journal no. N-20,160,030) approved the study.
- 1.Court-Brown CM. Rockwood and Green’s fractures in adults. Walters Kluwer, USA. 2015.Google Scholar
- 6.Boström Å. Fracture of the patella. A study of 422 patellar fractures. Acta Orthop Scand Suppl A. Bostrom; 1972, pp. 1–80.Google Scholar
- 20.Questionnary E-5d. Eq-5d questionnary. http://www.euroqol.org/about-eq-5d/publications/user-guide.html. Accessed June 2016.
- 23.KOOS questionnary [KOOS web site]. http://www.koos.nu. Accessed June 2016.
- 25.Colton C, Gebhard F, Kregor P, Oliver C. AO Classification of Patella Fractures [Internet]. AO Found. 2008 [cited 2016 Oct 7]. https://www2.aofoundation.org/wps/portal/surgery?showPage=diagnosis&bone=Knee&segment=Patella. Accessed June 2016.
- 36.Woo J, Lau E, Lee P, Kwok T, Lau WCS, Chan C, et al. Impact of osteoarthritis on quality of life in a Hong Kong Chinese population. J Rheumatol Can. 2004;31:2433–8.Google Scholar
- 38.Ziring E, Ishaque B, Ishaque N, Gotzen L. Fractures of the distal patella pole—treatment strategy and results. Acta Chir Austriaca. 2000. pp. 115–8.Google Scholar
- 39.Ishaque B, Ziring E, Ishaque N, Petermann J, Gotzen L. Therapeutic concept and follow-up results after proximal avulsion injuries of patellar ligament and fractures of the distal patella pole. Unfallchirurgie. 1999. pp. 165–73.Google Scholar
- 44.Singh JA, Tugwell P, Zanoli G, Wells GA. Total joint replacement surgery for knee osteoarthritis and other non-traumatic diseases: a network meta-analysis. Cochrane Database Syst Rev. 2015.Google Scholar