内侧髌股韧带重建术后并发症发生率为0%至32%，复发性不稳定发生率为0%至11%：一项系统评价。
Complication Rates After Medial Patellofemoral Ligament Reconstruction Range From 0% to 32% With 0% to 11% Recurrent Instability: A Systematic Review.
作者信息
Jackson Garrett R, Tuthill Trevor, Gopinatth Varun, Mameri Enzo S, Jawanda Harkirat, Sugrañes Joan, Asif Shaan, Wessels Morgan, McCormick Johnathon R, Kaplan Daniel J, Yanke Adam B, Knapik Derrick M, Verma Nikhil N, Chahla Jorge
机构信息
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.; Instituto Brasil de Tecnologia da Saúde, Rio de Janeiro, Brazil; Department of Orthopedics and Traumatology, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.
出版信息
Arthroscopy. 2023 May;39(5):1345-1356. doi: 10.1016/j.arthro.2023.01.098. Epub 2023 Feb 9.
PURPOSE
To review the incidence of complications following primary medial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability.
METHODS
A literature search was conducted by querying PubMed and Scopus databases from database inception through August 2022 according to the 2020 Preferred Reporting Items for Systematic Review and Meta-analysis guidelines using the terms "Medial Patellofemoral Ligament," "MPFL," "reconstruction," "patellar," and "instability." Inclusion criteria included studies reporting complications following primary MPFL reconstruction for recurrent patellar instability. Exclusion criteria consisted of studies reporting on patients undergoing concurrent osteotomy procedures, revision reconstruction, and biomechanical or anatomic studies. The incidence of specific complications was aggregated from the included studies.
RESULTS
Twenty-eight studies, consisting of 1,478 patients (n = 1521 knees), with a mean age of 23.3 years (mean range, 19-34.3 years) were identified. The overall incidence of complications ranged from 0% to 32.3% of knees. Failure ranged from 0% to 10.7% of knees, whereas patellar fractures occurred in 0% to 8.3% of knees, primarily in patients treated with full-length transverse tunnel or 2-tunnel techniques. All patellar fractures occurred in patients with patellar tunnels ranging from 4.5 to 6.0 mm in diameter. The incidence of postoperative knee stiffness/range of motion deficit ranged from 0% to 20%. Persistent anterior knee pain, ranged from 0% to 32.3%.
CONCLUSIONS
Complications following primary MPFL reconstruction ranged from 0% to 32.3% of knees, primarily consisting of residual anterior knee pain. Failure ranged from 0% to 10.7% of knees, whereas patellar fractures were reported in 0% to 8.3% of knees. Fractures primarily occurred with a full-length transverse tunnel or 2-tunnel techniques, whereas all fractures occurred with patellar tunnels ranging from 4.5 mm to 6.0 mm in diameter.
LEVEL OF EVIDENCE
IV; Systematic Review of Level I-IV studies.
目的
回顾初次内侧髌股韧带（MPFL）重建治疗复发性髌骨不稳后并发症的发生率。
方法
根据2020年系统评价和Meta分析的首选报告项目指南，通过查询PubMed和Scopus数据库，从数据库建立至2022年8月，使用“内侧髌股韧带”“MPFL”“重建”“髌骨”和“不稳”等术语进行文献检索。纳入标准包括报告初次MPFL重建治疗复发性髌骨不稳后并发症的研究。排除标准包括报告同时进行截骨手术、翻修重建以及生物力学或解剖学研究的患者的研究。从纳入的研究中汇总特定并发症的发生率。
结果
共确定了28项研究，涉及1478例患者（n = 1521膝），平均年龄23.3岁（平均范围19 - 34.3岁）。并发症的总体发生率在0%至32.3%的膝关节之间。失败率在0%至10.7%的膝关节之间，而髌骨骨折发生在0%至8.3%的膝关节，主要发生在采用全长横向隧道或双隧道技术治疗的患者中。所有髌骨骨折均发生在直径为4.5至6.0毫米的髌骨隧道患者中。术后膝关节僵硬/活动范围受限的发生率在0%至20%之间。持续性膝前疼痛的发生率在0%至32.3%之间。
结论
初次MPFL重建后并发症的发生率在0%至32.3%的膝关节之间，主要为残留膝前疼痛。失败率在0%至10.7%的膝关节之间，而髌骨骨折报告发生率在0%至8.3%的膝关节之间。骨折主要发生在采用全长横向隧道或双隧道技术时，而所有骨折均发生在直径为4.5毫米至6.0毫米的髌骨隧道患者中。
证据级别
IV；I - IV级研究的系统评价
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