Department of Orthopedic Surgery, Noordwest Hospital, T.a.V. CORAL, Postbus 501, 1800 AM, Alkmaar, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2021 Apr;29(4):1137-1149. doi: 10.1007/s00167-020-06114-1. Epub 2020 Jun 27.
To assess the different surgical techniques and their outcomes following tibial tubercle transfer (TTT) in patients with patellar maltracking.
A systematic search of the literature was performed in PubMed, EMBASE and Cochrane Library. Studies reporting patient-reported outcome measures (PROMs) or clinical outcome following: TTT in patients with patellar maltracking were included. Collected PROMs were Lysholm, Kujala, IKDC score, and VAS pain. Clinical outcome included reported clinical success, patient satisfaction, complications and removal of hardware (ROH). Overall pre-, post-operative and change scores were estimated using random-effects meta-analysis models. Results were reported as overall mean and per transfer direction.
A total of 26 studies and 761 patients (818 knees, mean age 35 years, mean follow-up 5.0 years) were included. In 73% of the studies, surgery was performed after failed conservative treatment. Transfer direction was anteromedial in 76% of all procedures. Overall Lysholm score improved from 61 to 91, Kujala from 52 to 85, IKDC from 53 to 81, and VAS from 6.2 to 2.5, respectively. Clinical success was reported in 79% of patients, and 80% of patients reported to have satisfactory results. Rates of complications and ROH were 13% and 29%, respectively.
TTT for management of patellar maltracking can lead to good results with clinically meaningful improvement, an overall clinical success of 79% and overall patient satisfaction of 80% when appreciating the underlying anatomic condition and using appropriate technique. The level of evidence was low, and large-scale prospective, comparative cohort studies with uniform outcome scales are needed to confirm these findings.
IV.
评估髌骨轨迹不良患者行胫骨结节转移术（TTT）的不同手术技术及其效果。
在 PubMed、EMBASE 和 Cochrane Library 中进行了系统的文献检索。纳入报告患者报告的结局测量（PROM）或髌骨轨迹不良患者行 TTT 后临床结局的研究。收集的 PROM 包括 Lysholm、Kujala、IKDC 评分和 VAS 疼痛。临床结局包括报告的临床成功率、患者满意度、并发症和内固定去除（ROH）。使用随机效应荟萃分析模型估计总体术前、术后和变化评分。结果以总体平均值和每转移方向报告。
共纳入 26 项研究和 761 名患者（818 膝，平均年龄 35 岁，平均随访 5.0 年）。73%的研究中，手术是在保守治疗失败后进行的。76%的手术中转移方向为前内侧。总体 Lysholm 评分从 61 分提高到 91 分，Kujala 从 52 分提高到 85 分，IKDC 从 53 分提高到 81 分，VAS 从 6.2 分降低到 2.5 分。79%的患者报告临床成功率，80%的患者报告结果满意。并发症和 ROH 的发生率分别为 13%和 29%。
对于髌骨轨迹不良的治疗，TTT 可以带来良好的效果，具有临床意义的改善，总体临床成功率为 79%，总体患者满意度为 80%，前提是要了解潜在的解剖条件并使用适当的技术。证据水平较低，需要进行大规模的前瞻性、对照队列研究，并使用统一的结局量表来证实这些发现。
IV。
