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Does medial patellofemoral ligament reconstruction result in femoral tunnel enlargement? A systematic review
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Abelleyra Lastoria, Diego Agustín, Gopinath, Vathana, Divekar, Omkaar, Smith, Toby O., Roberts, Tobias R. W. and Hing, Caroline B. (2023) Does medial patellofemoral ligament reconstruction result in femoral tunnel enlargement? A systematic review. Knee Surgery & Related Research, 35 (1). 13. doi:10.1186/s43019-023-00187-1 ISSN 2234-2451.
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Official URL: https://doi.org/10.1186/s43019-023-00187-1
Abstract
Background: Medial patellofemoral ligament (MPFL) reconstruction is a common surgical procedure for treating patellar instability. The primary aim of this systematic review was to determine whether MPFL reconstruction (MPFLR) leads to femoral tunnel enlargement (FTE). The secondary aims were to explore the clinical effects and risk factors of FTE. Electronic databases (MEDLINE, Global Health, Embase), currently registered studies, conference proceedings and the reference lists of included studies were searched independently by three reviewers. There were no constraints based on language or publication status. Study quality assessment was conducted. 3824 records were screened in the initial search. Seven studies satisfied the inclusion criteria, evaluating 380 knees in 365 patients. Rates of FTE following MPFLR ranged from 38.7 to 77.1%. Five low quality studies reported FTE did not lead to detrimental clinical outcomes as assessed with the Tegner, Kujala, IKDC, and Lysholm scores. There is conflicting evidence regarding change in femoral tunnel width over time. Three studies (of which two had a high risk of bias) reported age, BMI, presence of trochlear dysplasia and tibial tubercle-tibial groove distance did not differ between patients with and without FTE, suggesting these are not risk factors for FTE. Conclusion: FTE is a common postoperative event following MPFLR. It does not predispose poor clinical outcomes. Current evidence lacks the ability to identify its risk factors. The reliability of any conclusions drawn is hindered by the low level of evidence of the studies included in this review. Larger prospective studies with long-term follow up are required to reliably ascertain the clinical effects of FTE.
| Item Type: | Journal Article | ||||||
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| Subjects: | Q Science > QM Human anatomy R Medicine > RD Surgery |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Patellofemoral joint -- Surgery, Patellofemoral joint -- Wounds and injuries, Patellofemoral joint -- Diseases, Knee -- Surgery, Femur -- Surgery, Surgery -- Risk factors -- Research, Systematic reviews (Medical research) | ||||||
| Journal or Publication Title: | Knee Surgery & Related Research | ||||||
| Publisher: | BioMed Central | ||||||
| ISSN: | 2234-2451 | ||||||
| Official Date: | 2 May 2023 | ||||||
| Dates: |
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| Volume: | 35 | ||||||
| Number: | 1 | ||||||
| Article Number: | 13 | ||||||
| DOI: | 10.1186/s43019-023-00187-1 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Reuse Statement (publisher, data, author rights): | |||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 4 May 2023 | ||||||
| Date of first compliant Open Access: | 10 May 2023 | ||||||
| Related URLs: |
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