Department of Orthopaedics, Orthopedic Clinical Medical Research Center of Gansu Province, Intelligent Orthopedic Industry Technology Center of Gansu Province, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, People's Republic of China.
J Orthop Surg Res. 2023 Nov 1;18(1):822. doi: 10.1186/s13018-023-04265-8.
The purpose of the study was to summarize the available evidence and identify risk factors for osteochondral injuries (OCIs) after patellar dislocations.
A systematic literature review was conducted in PubMed, Embase, Web of Science, Cochrane Library, and China national knowledge infrastructure from inception to December 22, 2022, according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies regarding risk factors for OCIs after patellar dislocations were included. Literature search, data extraction, and quality assessment were performed independently by two authors.
A total of 16 studies with 1945 patients were included. The risk factors for OCIs after patellar dislocation were categorized into four main categories, including demographic characteristics, patellar depth and position, femoral trochlear morphology, and other risk factors in this study. Five and three studies supported the idea that male sex and skeletal maturation may be risk factors, respectively. Normal femoral trochlea (two studies) and complete medial patellofemoral ligament (MPFL) injuries (two studies) may be associated with the development of OCIs. Three studies show that ligamentous laxity or joint hypermobility may prevent OCIs. Patellar depth and position (eight studies) may not be associated with the development of OCIs.
Based on the available evidence, an increased risk of OCIs following patellar dislocation may be associated with male sex and skeletal maturation. Furthermore, normal femoral trochlea and complete MPFL injuries may increase the risk of OCIs, while factors such as ligamentous laxity or joint hypermobility may reduce the risk.
Level IV, systematic review of Level II and IV studies.
本研究旨在总结现有的证据，并确定髌骨脱位后骨软骨损伤（OCIs）的危险因素。
根据系统评价和荟萃分析报告的首选项目，我们在 PubMed、Embase、Web of Science、Cochrane 图书馆和中国国家知识基础设施中进行了系统的文献检索，检索时间为从建库至 2022 年 12 月 22 日。纳入了关于髌骨脱位后 OCIs 危险因素的研究。文献检索、数据提取和质量评估由两位作者独立进行。
共纳入 16 项研究，共计 1945 例患者。髌骨脱位后 OCIs 的危险因素可分为四大类，包括本研究中的人口统计学特征、髌骨深度和位置、股骨滑车形态以及其他危险因素。有 5 项和 3 项研究分别支持男性和骨骼成熟可能是危险因素的观点。正常的股骨滑车（两项研究）和完全的内侧髌股韧带（MPFL）损伤（两项研究）可能与 OCIs 的发生有关。三项研究表明，韧带松弛或关节过度活动可能预防 OCIs。髌骨深度和位置（八项研究）可能与 OCIs 的发生无关。
基于现有证据，髌骨脱位后 OCIs 的风险增加可能与男性和骨骼成熟有关。此外，正常的股骨滑车和完全的 MPFL 损伤可能会增加 OCIs 的风险，而韧带松弛或关节过度活动等因素可能会降低风险。
IV 级，对 II 级和 IV 级研究的系统评价。
