Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
J Coll Physicians Surg Pak. 2024 May;34(5):584-594. doi: 10.29271/jcpsp.2024.05.584.
The purpose of this meta-analysis was to conduct a comparative analysis of clinical scores and complication rates among patients experiencing recurrent patellar dislocation who underwent medial patellofemoral ligament (MPFL) reconstruction using both single and double tunnel techniques. A comprehensive search was conducted across electronic databases including PubMed, the Cochrane Library, Web of Science, and Google Scholar to retrieve articles relevant to MPFL reconstruction utilising the tunnel technique. Subsequently, meta-analyses were undertaken to assess complication rates and changes in clinical scores before and after surgery. Following this, sensitivity analysis and meta-regression analysis were performed to scrutinise potential confounding variables. A total of thirty-two studies were included in the analysis, comprising twenty-seven non-comparative studies and five comparative studies. The findings revealed a similarity in postoperative complication rates between the single and double tunnel fixation techniques: [9.0% (95%CI, 4.0%-15.6%) versus 8.9% (95%CI, 4.7%-14.1%, p = 0.844)]. Likewise, no statistically significant differences were observed in Lysholm scores [34.1 (95%CI, 26.7-41.5) versus 33.8 (95%CI, 27.7-40.0, p = 0.956)], Kujala scores [29.4 (95%CI, 22.3-36.4) versus 27.3 (95%CI, 22.3-32.3, p = 0.637)], and Tegner score change [1.1 (95%CI, 0.8-1.4) versus 0.7 (95%CI, -0.2-1.6, p = 0.429)] before and after MPFL reconstruction, respectively, using these two techniques. In conclusion, the authors found that the clinical functional improvement and complication rates in MPFL reconstruction using the single tunnel fixation technique are comparable to those achieved with the double tunnel fixation approach. However, to further advance the understanding in this field, additional randomised controlled studies must be conducted to provide further insights. Key Words: MPFL reconstruction, Bone tunnel, Patellar dislocation, Meta-analysis.
本荟萃分析旨在对接受单隧道和双隧道技术进行内侧髌股韧带（MPFL）重建的复发性髌骨脱位患者的临床评分和并发症发生率进行比较分析。通过检索电子数据库（包括 PubMed、Cochrane 图书馆、Web of Science 和 Google Scholar），全面检索了有关使用隧道技术进行 MPFL 重建的文章。随后，进行荟萃分析以评估手术前后的并发症发生率和临床评分变化。之后，进行敏感性分析和荟萃回归分析，以检查潜在的混杂变量。共纳入 32 项研究，包括 27 项非对照研究和 5 项对照研究。研究结果表明，单隧道和双隧道固定技术的术后并发症发生率相似：[9.0%（95%CI，4.0%-15.6%）与 8.9%（95%CI，4.7%-14.1%，p=0.844）]。同样，在 Lysholm 评分方面也没有观察到统计学上的显著差异[34.1（95%CI，26.7-41.5）与 33.8（95%CI，27.7-40.0，p=0.956）]、Kujala 评分[29.4（95%CI，22.3-36.4）与 27.3（95%CI，22.3-32.3，p=0.637）]和 Tegner 评分变化[1.1（95%CI，0.8-1.4）与 0.7（95%CI，-0.2-1.6，p=0.429）]，分别使用这两种技术进行 MPFL 重建前后。总之，作者发现，单隧道固定技术进行 MPFL 重建的临床功能改善和并发症发生率与双隧道固定方法相当。然而，为了进一步深入了解这一领域，还需要进行更多的随机对照研究，以提供进一步的见解。关键词：MPFL 重建、骨隧道、髌骨脱位、荟萃分析。
