Department of Orthopaedic, University Clinic Aachen, RWTH Aachen University Clinic, Aachen, Germany.
Department of Orthopedics and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Surgeon. 2022 Aug;20(4):e112-e121. doi: 10.1016/j.surge.2021.03.003. Epub 2021 May 4.
Evidence concerning the influence gender, age, and the time elapsed from the first dislocation to surgery in the outcomes of Medial Patella Femoral Ligament (MPFL) reconstruction are lacking. This systematic review was conducted to investigate whether patient characteristics have an influence in the clinical outcomes of MPFL reconstruction for patients with patellofemoral instability.
This study followed the PRISMA guidelines. The main databases were accessed in February 2021. All the studies reporting outcomes of primary MPFL reconstruction in patients with recurrent patellofemoral instability were considered for inclusion. A multivariate analysis diagnostic tool was used to analyse the association between age, gender and time from injury to surgery and the surgical outcomes at last follow-up.
A total of 50 articles (2037 procedures) were included. The mean follow-up was 40.90 ± 24.8 months. The mean age was 23.6 ± 3.9 years. 64.3% (1309 of 2037 patients) were female. The mean time from injury to surgery was 64.5 ± 48.9 months. Women showed no statistically significant association with the Kujala score or complications. Older patients had a reduced risk to incur re-dislocations (P = 0.01) and revisions (P = 0.01). Longer time from injury to surgery was associated with greater risk to incur re-dislocations (P = 0.01), and with lower Kujala score (P < 0.0001). No other statistically significant association was evidenced.
The time span from the first patellar dislocation to the surgical reconstruction was a negative prognostic factor, while sex had no influence on surgical outcomes. The role of patients age on surgical outcomes remains unclear.
关于性别、年龄以及初次脱位至手术时间对内侧髌股韧带（MPFL）重建结果的影响，目前尚无相关证据。本系统评价旨在探讨患者特征是否会影响髌股不稳定患者 MPFL 重建的临床结果。
本研究遵循 PRISMA 指南。主要数据库于 2021 年 2 月进行检索。所有报告复发性髌股不稳定患者初次 MPFL 重建结果的研究均被纳入。使用多变量分析诊断工具分析年龄、性别和受伤至手术时间与末次随访时手术结果之间的关联。
共纳入 50 篇文章（2037 例手术）。平均随访时间为 40.90±24.8 个月。平均年龄为 23.6±3.9 岁。64.3%（1309/2037 例）为女性。受伤至手术的平均时间为 64.5±48.9 个月。女性与 Kujala 评分或并发症之间无统计学显著相关性。年龄较大的患者发生再脱位（P=0.01）和翻修（P=0.01）的风险降低。受伤至手术时间延长与再脱位（P=0.01）和 Kujala 评分降低（P<0.0001）的风险增加相关。未发现其他具有统计学显著意义的相关性。
从初次髌骨脱位到手术重建的时间跨度是一个负面的预后因素，而性别对手术结果没有影响。患者年龄对手术结果的作用尚不清楚。
