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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 1/2019

01-01-2019 | Arthroscopy and Sports Medicine

No influence of patellar fixation technique on clinical outcomes of double-bundle medial patellofemoral ligament reconstruction: a systematic review

Authors: Huijun Kang, Rui Zheng, Conglei Dong, Kunpeng Fu, Fei Wang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2019

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Abstract

Purpose

To compare clinical outcomes of double-bundle medial patellofemoral ligament (MPFL) reconstruction with different patellar fixation techniques including Kujala score, functional failure and complications.

Methods

Pubmed, Embase, and Cochrane Library databases were searched for studies with clinical results of double-bundle MPFL reconstruction. The hamstring tendon autografts were used, and femoral fixation was performed with bone tunnel and an interference screw, and knee fixation angle was less than or equal to 45°. Patellar fixation methods were broadly categorized into 3 treatment groups: suture anchor (SA), bone tunnel (BT) and suture techniques (SU). Pooled means for Kujala score and pooled estimates for functional failure rate and complication rate were compared.

Results

21 studies (23 groups) consisting of 691 knees met the inclusion criteria. 12 groups with 344 knees were in SA group, 5 groups of 161 knees were in BT group and 6 groups with 186 knees were in SU group. Statistically significant differences in Kujala score were found among three groups, 90.2 (95% CI 88.7–91.7) in SA group, 88.7 (95% CI 85.3–92.2) in BT group and 89.4 (95% CI 84.2–94.6) in SU group (all P < 0.001), but these differences were not clinically significant. No statistically significant differences were found in the positive apprehension sign rate, recurrent subluxation or dislocation rate, and major or minor complication rate among three groups.

Conclusion

Patellar fixation with bone tunnel, suture anchor or suture techniques were all effective in the double-bundle MPFL reconstruction. The present systematic review failed to show that one technique was better than the others. More high-quality trials and randomized controlled trials are needed.
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Metadata
Title
No influence of patellar fixation technique on clinical outcomes of double-bundle medial patellofemoral ligament reconstruction: a systematic review
Authors
Huijun Kang
Rui Zheng
Conglei Dong
Kunpeng Fu
Fei Wang
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 1/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-3008-8

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