摘要：Highlights
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Recurrent instability of the patellofemoral joint has higher prevalence in active and young populations. After the first patellar dislocation, up to 96% of patients present damage to the medial patellofemoral ligament and reconstruction may be necessary.
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Femoral graft fixation through interference screw produced similar clinical scores and complications compared to the anchors for primary isolated medial patellofemoral reconstruction in patients with recurrent patellofemoral instability at mid- to long-term follow-up.
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This study has several limitations, but they are mainly due to the lack of studies in the literature. Thus, data from the present study must be interpreted with caution.
Purpose
The present study aimed to systematically review and compare 2 femoral autograft fixation techniques, namely, interference screws and suture anchors, for isolated medial patellofemoral ligament reconstruction in patients with recurrent patellofemoral instability at mid- to long-term follow-up.
Methods
A literature search was performed in September 2020. All studies reporting the outcomes of primary isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability were considered for inclusion. Only studies reporting the type of femoral autograft fixation under examination were considered. Studies reporting data from patients with elevated tibial tuberosity-tibial groove, patella alta, and/or Dejour's trochlear dysplasia types C and D, were not included. Only articles reporting data with a minimum follow-up period of 18 months were considered.
Results
Data from 19 studies (615 patients) were retrieved. The overall age was 24.4 ± 6.7 years (mean ± SD). The mean follow-up was 46.5 ± 20.9 months. There were 76 patients in the anchor group and 539 in the screw group. Comparability was found with regard to age and follow-up duration between the 2 study groups. There was comparability between the Kujala, Lysholm, and Tegner scores at baseline. At the last follow-up, no worthy differences were found in terms of mean Kujala (+2.1%;
p = 0.04), Lysholm (+1.7%;
p = 0.05), and Tegner (+15.8%;
p = 0.05) scores. Although complications occurred almost exclusively in the screw cohort, no statistically significant difference was found.
Conclusion
Femoral autograft fixation through interference screws or suture anchors report similar clinical scores and rate of apprehension test, persistent joint instability, re-dislocations, and revisions. These results must be interpreted within the limitations of the present study.
Graphical Abstract
Image, graphical abstract
