Altered long-term health-related quality of life in patients following patella fractures: A long-term follow-up study of 49 patients

Introduction: 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. Methods: 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. Results: 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). Conclusion: At 8.5 years following a patella fracture, HRQOL was significantly worse compared to an age-matched reference population.