使用合成移植物进行 MPFL 重建手术:临床结果的系统回顾。

Panayiotis Tanos, Chryssa Neo, Edwin Tong, Andrea Volpin
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引用次数: 0

摘要

(1) 背景:急性髌骨脱位(APD)是一种常见的膝关节损伤,发病率为每十万人中 5.8-77.8 例。由于髌骨股骨内侧韧带(MPFL)不稳定,急性髌骨脱位通常会导致髌骨外侧反复脱位。非手术治疗的复发率为50%。虽然自体移植物治疗 MPFL 一直受到青睐,但外科医生现在正在探索合成移植物。我们旨在评估合成移植物在反复髌骨脱位的 MPFL 重建手术中的有效性;(2)方法:我们的研究基于对美国国家健康与临床优化研究所医疗数据库的全面检索,并使用修改后的科尔曼方法评分进行质量评估;(3)结果:六项研究符合纳入标准。共纳入 284 名患者和 230 个膝关节。根据克罗斯比和英索尔分级系统,75%的患者临床疗效被评为优-良。国际膝关节文献委员会评分和膝关节损伤与骨关节炎结果评分显示,术后改善率分别为59%和60%;(4)结论:所有研究均显示术后功能结果有所改善,且未报告严重不良事件。事实证明,6 毫米 LARS(Orthomedic Ltd., Dollard-des-Ormeaux, QC, Canada)作为双束移植物使用时,对术后效果的改善最大。
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The Use of Synthetic Graft for MPFL Reconstruction Surgery: A Systematic Review of the Clinical Outcomes.

(1) Background: Acute patella dislocation (APD) is a prevalent knee injury, with rates between 5.8-77.8 per 100,000. APD often results in repeat lateral patella dislocations due to the instability of the medial patellofemoral ligament (MPFL). Non-operative treatments have a 50% recurrence rate. While autologous grafting for MPFL has been favored, surgeons are now exploring synthetic grafts. We aimed to assess the effectiveness of synthetic grafts in MPFL reconstruction surgeries for repeated patellar dislocations; (2) Methods: Our research was based on a thorough search from the National Institute of Health and Clinical Excellence Healthcare Databases, using the Modified Coleman Methodology Score for quality assessment; (3) Results: Six studies met the inclusion criteria. A total of 284 patients and 230 knees were included. Seventy-five percent of patients were graded to have excellent-good clinical outcomes using the Crosby and Insall Grading System. International Knee Documentation Committee score and Knee injury and Osteoarthritis Outcome Score scores showed 59% and 60% post-operative improvement, respectively; (4) Conclusions: All studies showed improvement in post-operative functional outcomes and report no serious adverse events. The 6 mm, LARS (Orthomedic Ltd., Dollard-des-Ormeaux, QC, Canada) proved to have the most improvement in post-operative outcomes when used as a double bundle graft.

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