Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis
Abstract Purpose To compare the clinical efficacy of single‐bundle versus double‐bundle reconstruction of the medial patellofemoral ligament (MPFL) for recurrent patellar dislocation (RPD) regarding knee function scores, postoperative complications, and imaging assessments. Methods A computerized se...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-10-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jeo2.70112 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850033072618078208 |
|---|---|
| author | Yiheng Wu Junran Li Hongbo Zhao Hongyan Zhou Bokai Wang Jinlong Zhang Shengkun Zhao |
| author_facet | Yiheng Wu Junran Li Hongbo Zhao Hongyan Zhou Bokai Wang Jinlong Zhang Shengkun Zhao |
| author_sort | Yiheng Wu |
| collection | DOAJ |
| description | Abstract Purpose To compare the clinical efficacy of single‐bundle versus double‐bundle reconstruction of the medial patellofemoral ligament (MPFL) for recurrent patellar dislocation (RPD) regarding knee function scores, postoperative complications, and imaging assessments. Methods A computerized search of PubMed, Cochrane Library, Embase, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), and VIP Database was performed for single‐bundle versus double‐bundle reconstruction of the medial patellofemoral ligament for treatment of RPD. Randomized controlled trials (RCTs) were evaluated for quality using the risk‐of‐bias evaluation tool recommended by the Cochrane Collaboration Network, and Cohort studies (CSs) were assessed using the Newcastle‐Ottawa Scale (NOS) scale. Meta‐analysis was performed using RevMan 5.3 software and STATA 16.0. Results Thirteen studies were included, four randomized controlled studies, and nine cohort studies. The level of evidence for the four randomized controlled studies was Ⅰ, and the nine cohort studies were Ⅲ. A total of 862 (891 knees) patients were included, of which 448 (465 knees) underwent double‐bundle MPFL reconstruction and 414 (426 knees) underwent single‐bundle MPFL reconstruction. Kujala score (MD = 2.06, 95% confidence interval [CI] [0.11, 4.01], p < 0.05), Tegner score (MD = 0.39, 95% CI [0.11, 0.68], p < 0.05), International Knee Documentation Committee (IKDC) score (MD = 4.88, 95% CI [1.46, 8.31], p < 0.05), and postoperative recurrence instability (odds ratio [OR] = 0.12, 95% CI [0.04, 0.44], p < 0.05) were better in the double‐bundle group than in the single‐bundle group. Lysholm score (MD = 0.86, 95% CI [−0.76, 2.48], p = n.s), patellar tilt angle (MD = −0.22, 95% CI [−0.54, 0.10], p = n.s), patellar lateral shift rate (MD = −0.16, 95% CI [−0.41, 0.09], p = n.s), congruence angle (MD = 0.06, 95% CI [−0.41, 0.52], p = n.s), postoperative knee pain (OR = 0.39, 95% CI [0.14, 1.11], p = n.s), and additional postoperative surgical treatment (OR = 0.20, 95% CI [0.01−6.25], p = n.s) had no statistically significant differences. Conclusions Double‐bundle reconstruction of the medial patellofemoral ligament for RPD was superior to single‐bundle reconstruction in both knee function scores and postoperative recurrent patellar instability, and double‐bundle reconstruction of the medial patellofemoral ligament for RPD had better clinical outcomes. Level of Evidence Level Ⅲ, Ⅰ and Ⅲ studies. |
| format | Article |
| id | doaj-art-4c907558067d4fd2b4e5f2a8a2253dcd |
| institution | DOAJ |
| issn | 2197-1153 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj-art-4c907558067d4fd2b4e5f2a8a2253dcd2025-08-20T02:58:21ZengWileyJournal of Experimental Orthopaedics2197-11532024-10-01114n/an/a10.1002/jeo2.70112Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysisYiheng Wu0Junran Li1Hongbo Zhao2Hongyan Zhou3Bokai Wang4Jinlong Zhang5Shengkun Zhao6Department of Orthopedics, The Second Hospital of Tangshan Graduate School of North China University of Science and Technology Tangshan ChinaDepartment of Orthopedics The Second Hospital of Tangshan Tangshan ChinaDepartment of Orthopedics The Second Hospital of Tangshan Tangshan ChinaDepartment of Orthopedics The Second Hospital of Tangshan Tangshan ChinaDepartment of Orthopedics, The Second Hospital of Tangshan Graduate School of North China University of Science and Technology Tangshan ChinaDepartment of Orthopedics, The Second Hospital of Tangshan Graduate School of North China University of Science and Technology Tangshan ChinaDepartment of Orthopedics Tangshan Central Hospital Tangshan ChinaAbstract Purpose To compare the clinical efficacy of single‐bundle versus double‐bundle reconstruction of the medial patellofemoral ligament (MPFL) for recurrent patellar dislocation (RPD) regarding knee function scores, postoperative complications, and imaging assessments. Methods A computerized search of PubMed, Cochrane Library, Embase, China Biomedical Literature Database (CBM), China National Knowledge Network (CNKI), and VIP Database was performed for single‐bundle versus double‐bundle reconstruction of the medial patellofemoral ligament for treatment of RPD. Randomized controlled trials (RCTs) were evaluated for quality using the risk‐of‐bias evaluation tool recommended by the Cochrane Collaboration Network, and Cohort studies (CSs) were assessed using the Newcastle‐Ottawa Scale (NOS) scale. Meta‐analysis was performed using RevMan 5.3 software and STATA 16.0. Results Thirteen studies were included, four randomized controlled studies, and nine cohort studies. The level of evidence for the four randomized controlled studies was Ⅰ, and the nine cohort studies were Ⅲ. A total of 862 (891 knees) patients were included, of which 448 (465 knees) underwent double‐bundle MPFL reconstruction and 414 (426 knees) underwent single‐bundle MPFL reconstruction. Kujala score (MD = 2.06, 95% confidence interval [CI] [0.11, 4.01], p < 0.05), Tegner score (MD = 0.39, 95% CI [0.11, 0.68], p < 0.05), International Knee Documentation Committee (IKDC) score (MD = 4.88, 95% CI [1.46, 8.31], p < 0.05), and postoperative recurrence instability (odds ratio [OR] = 0.12, 95% CI [0.04, 0.44], p < 0.05) were better in the double‐bundle group than in the single‐bundle group. Lysholm score (MD = 0.86, 95% CI [−0.76, 2.48], p = n.s), patellar tilt angle (MD = −0.22, 95% CI [−0.54, 0.10], p = n.s), patellar lateral shift rate (MD = −0.16, 95% CI [−0.41, 0.09], p = n.s), congruence angle (MD = 0.06, 95% CI [−0.41, 0.52], p = n.s), postoperative knee pain (OR = 0.39, 95% CI [0.14, 1.11], p = n.s), and additional postoperative surgical treatment (OR = 0.20, 95% CI [0.01−6.25], p = n.s) had no statistically significant differences. Conclusions Double‐bundle reconstruction of the medial patellofemoral ligament for RPD was superior to single‐bundle reconstruction in both knee function scores and postoperative recurrent patellar instability, and double‐bundle reconstruction of the medial patellofemoral ligament for RPD had better clinical outcomes. Level of Evidence Level Ⅲ, Ⅰ and Ⅲ studies.https://doi.org/10.1002/jeo2.70112double‐bundlemedial patellofemoral reconstructionmeta‐analysisrecurrent patellar dislocationsingle‐bundle |
| spellingShingle | Yiheng Wu Junran Li Hongbo Zhao Hongyan Zhou Bokai Wang Jinlong Zhang Shengkun Zhao Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis Journal of Experimental Orthopaedics double‐bundle medial patellofemoral reconstruction meta‐analysis recurrent patellar dislocation single‐bundle |
| title | Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis |
| title_full | Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis |
| title_fullStr | Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis |
| title_full_unstemmed | Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis |
| title_short | Double‐bundle versus single‐bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation: A meta‐analysis |
| title_sort | double bundle versus single bundle medial patellofemoral ligament reconstruction for recurrent patellar dislocation a meta analysis |
| topic | double‐bundle medial patellofemoral reconstruction meta‐analysis recurrent patellar dislocation single‐bundle |
| url | https://doi.org/10.1002/jeo2.70112 |
| work_keys_str_mv | AT yihengwu doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT junranli doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT hongbozhao doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT hongyanzhou doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT bokaiwang doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT jinlongzhang doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis AT shengkunzhao doublebundleversussinglebundlemedialpatellofemoralligamentreconstructionforrecurrentpatellardislocationametaanalysis |