Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Am J Sports Med. 2019 Apr;47(5):1254-1262. doi: 10.1177/0363546518765458. Epub 2018 May 3.
Few studies to date have compared clinical outcomes in patients who have undergone medial patellofemoral ligament (MPFL) reconstruction using the suture anchor and double transpatellar tunnel fixation methods. This meta-analysis therefore compared the clinical results, including the patellar redislocation rate and improvement in functional scores, of suture anchor and double transpatellar tunnel fixation.
The recurrence rate and improvement in functional outcomes after surgery would be similar using the suture anchor and double transpatellar tunnel fixation methods.
Meta-analysis.
Studies evaluating MPFL reconstruction using either the suture anchor or double transpatellar tunnel technique for patellar site fixation were included if they reported the patellar redislocation rate after surgery and/or validated patient-reported outcomes such as the Kujala and Lysholm scores.
Twenty-one studies were included in this meta-analysis. The mean patellar redislocation rates were similar using the suture anchor (3.2% [95% CI, 1.6%-6.2%]) and double transpatellar tunnel (3.4% [95% CI, 2.1%-5.4%]) techniques ( P = .879). The mean improvement in the Kujala score from before to after MPFL reconstruction was greater using the suture anchor (37.2 [95% CI, 31.1-43.4]) method than the double transpatellar tunnel method (28.7 [95% CI, 21.2-36.1]) ( P = .018). However, the mean improvement in the Lysholm score did not differ significantly using the 2 techniques.
The patellar redislocation rate did not differ significantly in patients who underwent MPFL reconstruction using the suture anchor and double transpatellar tunnel fixation methods. The suture anchor fixation method, however, resulted in a greater degree of improvement in patient-reported outcomes.
目前为止，仅有少数研究比较了采用缝线锚钉和双髌腱隧道固定方法进行内侧髌股韧带（MPFL）重建的患者的临床结果。因此，本荟萃分析比较了缝线锚钉和双髌腱隧道固定的临床结果，包括髌骨再脱位率和功能评分的改善。
采用缝线锚钉和双髌腱隧道固定方法，手术后的复发率和功能结果的改善将相似。
荟萃分析。
如果研究报告了手术后髌骨再脱位率和/或验证了患者报告的结果，如 Kujala 和 Lysholm 评分，则纳入评估 MPFL 重建中采用缝线锚钉或双髌腱隧道技术进行髌骨部位固定的研究。
本荟萃分析纳入了 21 项研究。采用缝线锚钉（3.2%[95%可信区间，1.6%-6.2%]）和双髌腱隧道（3.4%[95%可信区间，2.1%-5.4%]）技术的平均髌骨再脱位率相似（P=.879）。与双髌腱隧道方法（28.7[95%可信区间，21.2-36.1]）相比，采用缝线锚钉方法（37.2[95%可信区间，31.1-43.4]）的 Kujala 评分从术前到术后的平均改善更大（P=.018）。然而，这两种技术的 Lysholm 评分的平均改善没有显著差异。
采用缝线锚钉和双髌腱隧道固定方法进行 MPFL 重建的患者，髌骨再脱位率无显著差异。然而，缝线锚钉固定方法可使患者报告的结果有更大程度的改善。
