PDF(Pubmed)
Abstract：
BACKGROUND: Medial patellar ligament reconstruction (MPFL-R) in combination with derotational distal femoral osteotomy (DDFO) for treating recurrent patellar dislocation (RPD) in the presence of increased femoral anteversion is one of the most commonly used surgical techniques in the current clinical practice. However, there are limited studies on the clinical outcomes of MPFL-R in combination with DDFO to treat RPD in the presence of increased femoral anteversion.
OBJECTIVE: To study the role of MPFL-R in combination with DDFO in the treatment of RPD in the presence of increased femoral anteversion.
METHODS: A systematic review was performed according to the PRISMA guidelines by searching the Medline, Embase, Web of Science, and Cochrane Library databases through June 1, 2023. Studies of patients who received MPFL-R in combination with DDFO after presenting with RPD and increased femoral anteversion were included. Methodological quality was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Each study\'s basic characteristics, including characteristic information, radiological parameters, surgical techniques, patient-reported outcomes, and complications, were recorded and analyzed.
RESULTS: A total of 6 studies with 231 patients (236 knees) were included. Sample sizes ranged from 12 to 162 patients, and the majority of the patients were female (range, 67-100%). The mean age and follow-up ranges were 18 to 24 years and 16 to 49 months, respectively. The mean femoral anteversion decreased significantly from 34° preoperatively to 12° postoperatively. In studies reporting preoperative and postoperative outcomes, significant improvements were found in the Lysholm score, Kujala score, International Knee Documentation Committee score, and visual analog scale for pain. Postoperative complications were reported in all studies, with an overall reported complication rate of 4.7%, but no redislocations occurred during the follow-up period.
CONCLUSIONS: For RPD with increased femoral anteversion, MPFL-R in combination with DDFO leads to a good clinical outcome and a low redislocation rate. However, there was no consensus among researchers on the indications for MPFL-R combined with DDFO in the treatment of RPD.
OBJECTIVE: To study the role of MPFL-R in combination with DDFO in the treatment of RPD in the presence of increased femoral anteversion.
METHODS: A systematic review was performed according to the PRISMA guidelines by searching the Medline, Embase, Web of Science, and Cochrane Library databases through June 1, 2023. Studies of patients who received MPFL-R in combination with DDFO after presenting with RPD and increased femoral anteversion were included. Methodological quality was assessed using the MINORS (Methodological Index for Nonrandomized Studies) score. Each study\'s basic characteristics, including characteristic information, radiological parameters, surgical techniques, patient-reported outcomes, and complications, were recorded and analyzed.
RESULTS: A total of 6 studies with 231 patients (236 knees) were included. Sample sizes ranged from 12 to 162 patients, and the majority of the patients were female (range, 67-100%). The mean age and follow-up ranges were 18 to 24 years and 16 to 49 months, respectively. The mean femoral anteversion decreased significantly from 34° preoperatively to 12° postoperatively. In studies reporting preoperative and postoperative outcomes, significant improvements were found in the Lysholm score, Kujala score, International Knee Documentation Committee score, and visual analog scale for pain. Postoperative complications were reported in all studies, with an overall reported complication rate of 4.7%, but no redislocations occurred during the follow-up period.
CONCLUSIONS: For RPD with increased femoral anteversion, MPFL-R in combination with DDFO leads to a good clinical outcome and a low redislocation rate. However, there was no consensus among researchers on the indications for MPFL-R combined with DDFO in the treatment of RPD.
摘要：
背景：髌内韧带重建（MPFL-R）联合股骨远端旋转截骨术（DDFO）治疗股骨前倾增加的复发性髌骨脱位（RPD）是目前临床实践中最常用的手术技术之一。然而,关于MPFL-R联合DDFO治疗股骨前倾增加的RPD的临床结局的研究有限.
目的：研究MPFL-R联合DDFO在股骨前倾增加的RPD治疗中的作用。
方法：根据PRISMA指南，通过搜索Medline进行系统评价，Embase,WebofScience,和Cochrane图书馆数据库到2023年6月1日。包括在出现RPD和股骨前倾增加后接受MPFL-R联合DDFO的患者的研究。使用MINORS（非随机研究方法学指数）评分评估方法学质量。每个研究的基本特征，包括特征信息，放射学参数，外科技术,患者报告的结果，和并发症，进行记录和分析。
结果：共纳入6项研究，涉及231例患者（236膝）。样本量从12到162名患者不等，大多数患者是女性(范围，67-100%）。平均年龄和随访范围为18至24岁和16至49个月，分别。平均股骨前倾从术前34°明显降低至术后12°。在报告术前和术后结果的研究中，Lysholm评分有显著改善，Kujala得分,国际膝关节文献委员会得分，和疼痛的视觉模拟量表。所有研究均报告了术后并发症，总体报告并发症率为4.7%，但随访期间未发生脱位。
结论：对于股骨前倾增加的RPD，MPFL-R与DDFO组合导致良好的临床结果和低的再脱位率。然而,研究人员对MPFL-R联合DDFO治疗RPD的适应症没有达成共识。
目的：研究MPFL-R联合DDFO在股骨前倾增加的RPD治疗中的作用。
方法：根据PRISMA指南，通过搜索Medline进行系统评价，Embase,WebofScience,和Cochrane图书馆数据库到2023年6月1日。包括在出现RPD和股骨前倾增加后接受MPFL-R联合DDFO的患者的研究。使用MINORS（非随机研究方法学指数）评分评估方法学质量。每个研究的基本特征，包括特征信息，放射学参数，外科技术,患者报告的结果，和并发症，进行记录和分析。
结果：共纳入6项研究，涉及231例患者（236膝）。样本量从12到162名患者不等，大多数患者是女性(范围，67-100%）。平均年龄和随访范围为18至24岁和16至49个月，分别。平均股骨前倾从术前34°明显降低至术后12°。在报告术前和术后结果的研究中，Lysholm评分有显著改善，Kujala得分,国际膝关节文献委员会得分，和疼痛的视觉模拟量表。所有研究均报告了术后并发症，总体报告并发症率为4.7%，但随访期间未发生脱位。
结论：对于股骨前倾增加的RPD，MPFL-R与DDFO组合导致良好的临床结果和低的再脱位率。然而,研究人员对MPFL-R联合DDFO治疗RPD的适应症没有达成共识。
