Kluczynski Melissa A, Miranda Luis, Marzo John M
Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York, USA.
Orthop J Sports Med. 2020 Dec 16;8(12):2325967120967338. doi: 10.1177/2325967120967338. eCollection 2020 Dec.
Medial patellofemoral ligament (MPFL) injuries are common in patients with acute lateral patellar dislocations, but the pattern of MPFL injuries is unclear, especially with respect to patient age.
The primary aim was to determine the prevalence of MPFL injuries according to the site of injury in patients with acute lateral patellar dislocations. The secondary aim was to compare the site of MPFL injuries in patients aged ≤16 versus >16 years.
Systematic review; Level of evidence, 4.
A systematic literature search was performed with PubMed, Embase, and CINAHL to identify articles published from January 1, 1999, to May 31, 2019, that examined the site of MPFL injuries in patients with acute patellar dislocations. The study design, sample size, age at injury, technique used for diagnosing MPFL injuries (magnetic resonance imaging, ultrasound, and/or surgery), and prevalence and site of MPFL injuries were extracted from each study. The pooled estimate of the proportion of MPFL injuries at each site was calculated (femur, patella, midsubstance, and combined sites of injury) as well as proportions stratified by age group (≤16 and >16 years).
The literature search yielded 420 unique articles, of which 52 were screened for eligibility; of these, 17 were excluded. Thus, a total of 35 articles (2558 patients) were included in the final analysis. The overall prevalence of MPFL injuries was 94.7% (95% CI, 91.2%-96.8%). Most MPFL injuries occurred at the patella (37.1% [95% CI, 30.8%-43.9%]), followed by the femur (36.8% [95% CI, 31.0%-43.0%]), combined sites (25.1% [95% CI, 20.7%-30.1%]), and the midsubstance (15.6% [95% CI, 13.2%-18.4%]). In patients aged ≤16 years, most MPFL injuries occurred at the patella (39.3% [95% CI, 27.9%-51.9%]), and in patients aged >16 years, most MPFL injuries occurred at the femur (47.2% [95% CI, 40.6%-54.0%]).
The prevalence of MPFL injuries in patients with acute patellar dislocations varied by site of injury and by age. MPFL injuries at the patella were most prevalent overall and in children and adolescents, and MPFL injuries at the femur were more prevalent in adults.
内侧髌股韧带（MPFL）损伤在急性髌骨外侧脱位患者中很常见，但MPFL损伤的模式尚不清楚，尤其是在患者年龄方面。
主要目的是根据急性髌骨外侧脱位患者的损伤部位确定MPFL损伤的患病率。次要目的是比较年龄≤16岁与>16岁患者的MPFL损伤部位。
系统评价；证据级别，4级。
通过PubMed、Embase和CINAHL进行系统文献检索，以确定1999年1月1日至2019年5月31日发表的研究急性髌骨脱位患者MPFL损伤部位的文章。从每项研究中提取研究设计、样本量、受伤年龄、用于诊断MPFL损伤的技术（磁共振成像、超声和/或手术）以及MPFL损伤的患病率和部位。计算每个部位MPFL损伤比例的合并估计值（股骨、髌骨、中间部分和联合损伤部位）以及按年龄组分层的比例（≤16岁和>16岁）。
文献检索产生了420篇独特的文章，其中52篇被筛选是否符合纳入标准；其中17篇被排除。因此，最终分析共纳入35篇文章（2558例患者）。MPFL损伤的总体患病率为94.7%（95%CI，91.2%-96.8%）。大多数MPFL损伤发生在髌骨（37.1%[95%CI，30.8%-43.9%]），其次是股骨（36.8%[95%CI，31.0%-43.0%]）、联合部位（25.1%[95%CI，20.7%-30.1%]）和中间部分（15.6%[95%CI，13.2%-18.4%]）。在年龄≤16岁的患者中，大多数MPFL损伤发生在髌骨（39.3%[95%CI，27.9%-51.9%]），而在年龄>16岁的患者中，大多数MPFL损伤发生在股骨（47.2%[95%CI，40.6%-54.0%]）。
急性髌骨脱位患者MPFL损伤的患病率因损伤部位和年龄而异。髌骨处的MPFL损伤总体上以及在儿童和青少年中最为普遍，而股骨处的MPFL损伤在成年人中更为普遍。
