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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2019

01-03-2019 | Knee

Single- and double-bundle medial patellofemoral ligament reconstruction procedures result in similar recurrent dislocation rates and improvements in knee function: a systematic review

Authors: Huijun Kang, Rui Zheng, Yike Dai, Jiangfeng Lu, Fei Wang

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2019

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Abstract

Purpose

To evaluate medial patellofemoral ligament (MPFL) reconstruction using hamstring tendon autografts using single-bundle (SB) and double-bundle (DB) techniques, and compare the clinical outcomes including the Kujala score, postoperative apprehension, recurrent subluxation or dislocation, and complications.

Methods

The PubMed, Embase, and Cochrane Library databases were searched for relevant literature using the terms ‘‘medial patellofemoral ligament’’ and ‘‘MPFL’’. The pooled mean values of improvement in the Kujala score were calculated by random effects meta-analysis. Unweighted estimates for the rates of postoperative apprehension, recurrent subluxation or dislocation, and complications were determined by dividing the total number of occurrences by the total number of knees.

Results

Thirty-one articles were included, involving 1063 patients (1116 knees). Two hundred and forty-four patients (254 knees) underwent SB reconstruction, while 819 patients (862 knees) underwent DB reconstruction. The pooled mean values of Kujala score improvement were similar in the SB group (30.1; 95% CI 26.6–33.6) and DB group (30.7; 95% CI 27.7–33.7). The SB group had a significantly greater rate of postoperative apprehension (7.9%) than the DB group (4.1%; P = 0.014). There were no significant differences between the two groups in the rates of recurrent subluxation or dislocation (1.2 and 1.6%) and complications (10.6 and 7.7%).

Conclusion

With variability in patient populations and surgical techniques, the DB procedure for isolated MPFL reconstruction demonstrates similar outcomes to the SB technique regarding improvement of knee function, recurrent subluxation or dislocation, and complications. The SB technique may have a greater risk of postoperative apprehension, whereas the DB technique may cause more stiffness.

Level of evidence

IV.
Appendix
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Metadata
Title
Single- and double-bundle medial patellofemoral ligament reconstruction procedures result in similar recurrent dislocation rates and improvements in knee function: a systematic review
Authors
Huijun Kang
Rui Zheng
Yike Dai
Jiangfeng Lu
Fei Wang
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5112-2

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