Department of Orthopaedics, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany.
Department of Orthopaedics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Knee Surg Sports Traumatol Arthrosc. 2022 Apr;30(4):1282-1291. doi: 10.1007/s00167-021-06569-w. Epub 2021 Apr 16.
This study updates the current evidence on the role of allografts versus autografts for medial patellofemoral ligament (MPFL) reconstruction in patients with patellofemoral instability.
The study was performed according to the PRISMA guidelines. In March 2021, a literature search in the main online databases was performed. Studies reporting quantitative data concerning primary MPFL reconstruction using an allograft were considered for inclusion. The Coleman Methodology Score was used to assess the methodological quality of the selected articles.
Data from 12 studies (474 procedures) were retrieved. The mean follow-up was 42.2 (15-78.5) months. The mean age was 21.1 ± 6.2 years. 64.9% (285 of 439) of patients were female. At the last follow-up, the Tegner (p < 0.0001), Kujala (p = 0.002) and the Lysholm (p < 0.0001) scores were minimally greater in the autografts. The similarity was found in the rate of persistent instability sensation and revision. The allograft group evidenced a lower rate of re-dislocations (p = 0.003).
Allografts may represent a feasible alternative to traditional autograft for MPFL reconstruction in selected patients with patellofemoral instability. Allograft tendons yielded similar PROMs, rates of persistent instability, and revision. Allograft reconstructions tended to have modestly lower re-dislocation rates.
IV.
本研究更新了异体移植物与自体移植物在治疗髌股不稳定患者的内侧髌股韧带（MPFL）重建中的作用的现有证据。
该研究根据 PRISMA 指南进行。2021 年 3 月，在主要在线数据库中进行了文献检索。纳入了报告使用同种异体移植物进行原发性 MPFL 重建的定量数据的研究。使用 Coleman 方法学评分评估所选文章的方法学质量。
共检索到 12 项研究（474 例手术）的数据。平均随访时间为 42.2（15-78.5）个月。平均年龄为 21.1±6.2 岁。64.9%（285/439）的患者为女性。在末次随访时，自体移植物组的 Tegner（p<0.0001）、Kujala（p=0.002）和 Lysholm（p<0.0001）评分均略有升高。在持续性不稳定感和翻修方面，两组的相似性。异体移植物组的再脱位率较低（p=0.003）。
异体移植物可能是髌股不稳定患者 MPFL 重建的一种可行的传统自体移植物替代物。同种异体肌腱的 PROMs、持续性不稳定和翻修率相似。异体重建术的再脱位率较低。
IV 级。
