Dworsky-Fried Joshua, Blackman Benjamin, Cohen Dan, Peterson Devin, Ayeni Olufemi R, Musahl Volker, de Sa Darren
Michael G. deGroote School of Medicine McMaster University Hamilton Ontario Canada.
School of Medicine University of Limerick Limerick Ireland.
J Exp Orthop. 2025 Jun 1;12(2):e70256. doi: 10.1002/jeo2.70256. eCollection 2025 Apr.
To assess the outcomes of surgical management of patellar instability in hypermobile patients.
Three online databases (PubMed, MEDLINE and EMBASE) were searched from inception to 27 September 2024, to identify studies investigating the surgical management options for patellar instability in hypermobile patients. Data pertaining to patient demographics, patient management, redislocation rates and Kujala scores were abstracted. Weighted means and meta-analyses were conducted to compare rates of redislocation as well as post-operative Kujala scores. However, data pooling was not performed in cases of high heterogeneity. The quality of included studies was assessed using the MINORS criteria.
A total of nine studies and 303 patients were included in this review. The pooled mean post-operative redislocation rate was 9% at a mean follow-up time of 45.4 months. The mean post-operative redislocation rate ranged from 7.3% to 28.5% following medial patellofemoral reconstruction (MPFLR). The mean post-operative Kujala score ranged from 64.3 to 95.3. The post-operative complication rate was 11.7%.
This systematic review demonstrated that surgical management, particularly MPFLR, of patellar instability in hypermobile patients may result in lower redislocation rates and favourable post-operative outcomes compared to non-operative management in non-hypermobile patients. The current available literature for this patient population is highly heterogeneous, indicating the need for high-quality studies to more accurately assess intrinsic risk factors and surgical techniques.
Level IV.
评估活动度过高患者髌骨不稳定的手术治疗效果。
检索了三个在线数据库（PubMed、MEDLINE和EMBASE），检索时间从建库至2024年9月27日，以确定关于活动度过高患者髌骨不稳定手术治疗方案的研究。提取了与患者人口统计学、患者管理、再脱位率和库贾拉评分相关的数据。进行加权均值和荟萃分析以比较再脱位率和术后库贾拉评分。然而，在异质性高的情况下未进行数据合并。使用MINORS标准评估纳入研究的质量。
本综述共纳入9项研究和303例患者。平均随访45.4个月时，汇总的术后再脱位率为9%。内侧髌股重建（MPFLR）术后的平均再脱位率在7.3%至28.5%之间。术后库贾拉评分的平均值在64.3至95.3之间。术后并发症发生率为11.7%。
本系统评价表明，与非活动度过高患者的非手术治疗相比，活动度过高患者髌骨不稳定的手术治疗，尤其是MPFLR，可能导致更低的再脱位率和良好的术后效果。目前针对该患者群体的现有文献异质性很高，这表明需要高质量的研究来更准确地评估内在风险因素和手术技术。
四级。
