A Systematic Review of Complications and Failures Associated With Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation

作者：Shah Jay N; Howard Jennifer S; Flanigan David C; Brophy Robert H; Carey James L; Lattermann Christian^*

来源：The American Journal of Sports Medicine, 2012, 40(8): 1916-1923.

DOI：10.1177/0363546512442330

• patellofemoral instability
• medial patellofemoral ligament
• MPFL reconstruction complications
• MPFL reconstruction techniques
• patellar dislocation

Background: Patellofemoral instability affects activities of daily living and hinders athletic participation. Over the past 2 decades, more attention has been paid to medial patellofemoral ligament (MPFL) reconstruction for the treatment of recurrent patellar dislocations/subluxations. Numerous techniques have been reported; however, there is no consensus regarding optimal reconstruction. %26lt;br%26gt;Purpose: This study sought to report on the various techniques for MPFL reconstruction described in the literature and to assess the rate of complications associated with the procedure. %26lt;br%26gt;Study Design: Meta-analysis. %26lt;br%26gt;Methods: A systematic review of the literature was performed in early October 2010 using keywords %26quot;medial patellofemoral ligament,%26quot; %26quot;MPFL,%26quot; %26quot;reconstruction,%26quot; %26quot;complication(s),%26quot; and %26quot;failure(s).%26quot; Articles meeting the inclusion criteria were reviewed. Graft choice, surgical technique, outcome measures, and complications were recorded and organized in a database. Descriptive statistical analysis was performed on the data collected. %26lt;br%26gt;Results: Twenty-five articles were identified and reviewed. A total of 164 complications occurred in 629 knees (26.1%). These adverse events ranged from minor to major including patellar fracture, failures, clinical instability on postoperative examination, loss of knee flexion, wound complications, and pain. Twenty-six patients returned to the operating room for additional procedures. %26lt;br%26gt;Conclusion: Medial patellofemoral ligament reconstruction has a high rate of success for patients with patellofemoral instability; however, the complication rate of 26.1% associated with this procedure is not trivial. This study quantified complications and documented the variety of complications reported in outcomes-based literature.

• 出版日期2012-8