Akhtar Muzammil, Aamer Sonia, Asad Mohammad, Razick Daniel, Jundi Mustafa, Shelton Trevor
California Northstate University College of Medicine, 9700 W Taron Drive, Elk Grove, CA, 95757, USA.
University of California Davis School of Medicine, 4610 X St, Sacramento, CA, 95817, USA.
J Clin Orthop Trauma. 2024 Dec 24;61:102883. doi: 10.1016/j.jcot.2024.102883. eCollection 2025 Feb.
To review outcomes of medial patellofemoral ligament reconstruction (MPFLR) using synthetic suture tape in biomechanical and clinical studies.
A comprehensive literature search was performed in three databases. Studies reporting biomechanical and/or clinical outcomes of MPFLR using synthetic suture tape were included. For clinical studies, the primary outcome measures included patient-reported outcomes (PROs) and adverse events.
Three biomechanical studies were included. One study reported stronger integrity of fixation with suture tape versus semitendinosus autografts. One study reported similar integrity of MPFLR with knotless anchor versus soft tissue fixation. Another study found suture tape fixation between 60° and 90° of knee flexion to avoid excessive medial patellofemoral joint contact pressure after MPFLR. Eight clinical studies with 287 patients and 317 knees (36.1 % male, pooled mean age: 23.2 years old, pooled mean follow-up: 41.6 months) were included. All studies reported significant preoperative to postoperative improvement for all PROs except for the Tegner score in one study. The range of PROs were as follows (preoperative and postoperative): Lysholm (32.8-72.0 and 78.0 to 96.7), Kujala (36.0-75.2 and 78.8 to 97.7), International Knee Documentation Committee (IKDC) (48.6-69.8 and 71.3 to 91.3), and Tegner (1.0-4.6 and 4.0 to 6.5). Two studies comparing suture tape with autografts (quadriceps and gracillis tendons) reported similar postoperative PROs. The pooled rate of adverse postoperative events was 8.2 %. The pooled rate of positive patellar apprehension tests at follow-up was 3.2 %.
Patients undergoing MPFLR with suture tape fixation achieved significant improvements in PROs and demonstrated low rates of postoperative complications. Compared to autograft fixation, suture tape fixation provided comparable or superior clinical and biomechanical outcomes.
回顾在生物力学和临床研究中使用合成缝线带进行内侧髌股韧带重建（MPFLR）的结果。
在三个数据库中进行了全面的文献检索。纳入报告使用合成缝线带进行MPFLR的生物力学和/或临床结果的研究。对于临床研究，主要结局指标包括患者报告的结局（PROs）和不良事件。
纳入三项生物力学研究。一项研究报告，与半腱肌自体移植相比，缝线带固定的完整性更强。一项研究报告，无结锚钉与软组织固定的MPFLR完整性相似。另一项研究发现，在膝关节屈曲60°至90°之间进行缝线带固定，可避免MPFLR后髌股内侧关节接触压力过大。纳入八项临床研究，共287例患者、317个膝关节（男性占36.1%，平均年龄23.2岁，平均随访时间41.6个月）。所有研究均报告，除一项研究中的Tegner评分外，所有PROs术前至术后均有显著改善。PROs的范围如下（术前和术后）：Lysholm评分（32.8 - 72.0和78.0至96.7）、Kujala评分（36.0 - 75.2和78.8至97.7）、国际膝关节文献委员会（IKDC）评分（48.6 - 69.8和71.3至91.3）以及Tegner评分（1.0 - 4.6和4.0至6.5）。两项比较缝线带与自体移植（股四头肌和股薄肌腱） 的研究报告了相似的术后PROs。术后不良事件的合并发生率为8.2%。随访时髌股恐惧试验阳性的合并发生率为3.2%。
采用缝线带固定进行MPFLR的患者在PROs方面取得了显著改善，术后并发症发生率较低。与自体移植固定相比，缝线带固定提供了相当或更好的临床和生物力学结果。
