Abelleyra Lastoria, DA; Gopinath, V; Divekar, O; Smith, T; Roberts, TRW; Hing, CB
(2023)
Does medial patellofemoral ligament reconstruction result in femoral tunnel enlargement? A systematic review.
Knee Surg Relat Res, 35 (1).
p. 13.
ISSN 2234-0726
https://doi.org/10.1186/s43019-023-00187-1
SGUL Authors: Hing, Caroline Blanca
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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: | Article | ||||||
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Additional Information: | © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | ||||||
Keywords: | Clinical outcomes, Femoral tunnel widening, Medial patellofemoral ligament reconstruction, Risk factors, Systematic review | ||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||
Journal or Publication Title: | Knee Surg Relat Res | ||||||
ISSN: | 2234-0726 | ||||||
Language: | eng | ||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||
PubMed ID: | 37131234 | ||||||
Go to PubMed abstract | |||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/115357 | ||||||
Publisher's version: | https://doi.org/10.1186/s43019-023-00187-1 |
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