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Abstract
Introduction Patellar instability is 10 times higher in the military population, even more with young recruits undergoing a rapid and significant increase in daily sports activity. Despite such prevalence, little data are available on the return to operational activities. The objective of this research was to study the return to operational active duty after patellar stabilisation and identify risk factors for military return failure.
Materials and methods We conducted a multicentre, retrospective study, involving French soldiers who underwent patellar stabilisation in a military hospital between January 2009 and June 2022. Epidemiological, clinical, surgical data and postoperative score evaluations were collected via an online questionnaire. The main criteria of analysis were the return to operational activity. Secondary criteria were the return to physical activity and functional results. We conducted a sub-group comparison between surgeries.
Results Among the 52 patients, 63% returned to operational activity in a mean time of 9±5.14 months. Persistent pain and flessum were significantly associated with failure (p<0.05). Average follow-up was 37.3 months. Regarding physical activity, 78% managed to return, 43% at a prior or higher level, the mean delay was 11.6±7.26 months. The mean postoperative Tegner score was 3.9±1.72. On functional results, the mean Lysholm score was 78.4±21 and the mean International Knee Documentation Committee (IKDC) score was 74±17.3. Persistent instability occurred in 4% of cases. The delay to prior physical level was significantly higher in tibial tuberosity transposition versus medial patella femoral ligament ligamentoplasty (p=0.016)
Conclusions Patellar instability represents a turning point in a military career. Despite effective stabilisation, nearly half of the patients will experience a decrease in their sports level, and 60% will fully regain their full duty activity. Clear and accurate information should be provided to military patients to prepare them for the foreseeable consequences.
- Orthopaedic sports trauma
- Knee
- Military Personnel
- Adult orthopaedics
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
Contributors OB: study design, supervision, final approval of the manuscript. CC: surgical procedures, writing–review and editing. MP and PTe: help, with statistical analysis, data interpretation. LMP and PTa: data collection. CL: literature review, writing, data analysis. Original draft preparation. AO: methodology, ethics approval. BdG: critical revision of the manuscript, validation. All authors contributed significantly to the work, reviewed the final manuscript and approved its submission. All authors agreed to be accountable for all aspects of the work. CL is the guarantor of this work and accepts full responsibility for the conduct of the study, access to the data and the decision to publish.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The views expressed in this material are those of the authors, and do not reflect the official policy or position of the French government, the Department of Defense, or the Department of the Army.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.