Department of Orthopedic Surgery, New York University Langone Health, New York, New York, USA.
Am J Sports Med. 2021 Mar;49(4):1094-1100. doi: 10.1177/0363546520947044. Epub 2020 Aug 31.
Medial patellofemoral ligament (MPFL) reconstruction is being performed more frequently in athletes experiencing recurrent patellar instability.
PURPOSE/HYPOTHESIS: The purpose was to systematically review the evidence in the orthopaedic sports medicine literature to determine both the rate and timing of return to play after MPFL reconstruction and the rate of further patellar instability. Our hypothesis was that there would be a high rate of return to play after MPFL reconstruction.
Systematic review.
A systematic literature search was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which utilized EMBASE, MEDLINE, and the Cochrane Library databases. Inclusion criteria for literature included clinical studies reporting on return to play after MPFL reconstruction. Rate of return to play, level of return, timing of return, rate of recurrent instability, and patient-reported outcomes were evaluated. Statistical analysis was performed using SPSS.
Our review found 27 studies including 1278 patients meeting our inclusion criteria. The majority of patients were women (58%), and the total group had a mean age of 22.0 years and a mean follow-up of 39.3 months. The overall rate of return to play was 85.1%, with 68.3% returning to the same level of play. The average time to return to play was 7.0 months postoperatively. The rate of recurrent instability events following reconstruction was 5.4%. There was an improvement in both mean visual analog scale, pain scores (preoperative: 4.3, postoperative: 1.6) and Tegner activity scores (preoperative: 4.8, postoperative: 5.5).
The overall rate of return to play was high after MPFL reconstruction for the treatment of recurrent patellar instability. However, a relatively high percentage of those patients were unable to return to their preoperative level of sport. Additionally, there was a moderate time taken to return to play, at approximately 7 months after the procedure.
内侧髌股韧带（MPFL）重建术在经历复发性髌骨不稳定的运动员中越来越频繁地进行。
目的/假设：目的是系统地回顾矫形运动医学文献中的证据，以确定 MPFL 重建后的重返赛场率和重返赛场时间，以及髌骨再次不稳定的发生率。我们的假设是，MPFL 重建后重返赛场的比例会很高。
系统评价。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行了系统的文献检索，该检索利用了 EMBASE、MEDLINE 和 Cochrane 图书馆数据库。文献纳入标准包括报告 MPFL 重建后重返赛场的临床研究。评估重返赛场率、重返赛场水平、重返赛场时间、复发性不稳定发生率和患者报告的结果。使用 SPSS 进行统计分析。
我们的综述共发现 27 项研究，包括符合纳入标准的 1278 名患者。大多数患者为女性（58%），总组的平均年龄为 22.0 岁，平均随访时间为 39.3 个月。重返赛场的总体比例为 85.1%，其中 68.3%回到了相同的运动水平。术后重返赛场的平均时间为 7.0 个月。重建后复发性不稳定事件的发生率为 5.4%。重建后，平均视觉模拟评分（术前：4.3，术后：1.6）和 Tegner 活动评分（术前：4.8，术后：5.5）均有所改善。
对于复发性髌骨不稳定的治疗，MPFL 重建后的重返赛场率较高。然而，相当一部分患者无法恢复到术前的运动水平。此外，大约在手术后 7 个月才能够重返赛场，这需要相当长的时间。
