1. Lateral retinacular release combined with MPFL reconstruction for patellofemoral instability: a systematic review
- Author
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Jörg Eschweiler, Markus Tingart, Valentin Quack, Filippo Migliorini, Nicola Maffulli, and Arne Driessen
- Subjects
Lateral retinacular release ,Joint Instability ,medicine.medical_specialty ,Patellofemoral instability ,Dislocations ,Patellofemoral Joint ,03 medical and health sciences ,0302 clinical medicine ,Patellofermoral instability ,MPFL reconstruction ,medicine ,Humans ,Orthopedic Procedures ,Orthopedics and Sports Medicine ,In patient ,030222 orthopedics ,Lateral release ,Lateral retinaculum ,business.industry ,030229 sport sciences ,General Medicine ,Evidence-based medicine ,Plastic Surgery Procedures ,Surgery ,Arthroscopy and Sports Medicine ,Treatment Outcome ,medicine.anatomical_structure ,Orthopedic surgery ,Ligament ,business - Abstract
IntroductionThe role of the lateral retinaculum in patellofemoral instability is still debated. Lateral retinacular release (LRR), has been extensively performed in combination with different surgical procedures, including reconstruction of medio-patellofemoral ligament (MPFL). Despite controversial indications, the results from these studies seem promising. The present study conducts a systematic review about current biomechanical and clinical evidence concerning the role of LRR in combination with MPFL reconstruction. We performed a comprehensive literature research, comparing the outcomes of MPFL reconstruction with and without LRR.Materials and methodsThis systematic review was conducted according to the PRISMA guidelines. The literature search was performed in August 2020. All articles describing the outcome of isolated MPFL reconstruction alone or in combination with a LRR in patients with recurrent patellofemoral instability were considered for inclusion. Only articles reporting data on patients with a minimum of 12-month follow-up were included. Only articles reporting quantitative data under the outcomes of interest were included.ResultsA total of 63 articles were eligible for this systematic review, including 2131 knees. The mean follow-up was 40.87 ± 24.1 months. All scores of interests improved in favour of the combined group: Kujala + 3.8% (P = 0.01), Lysholm + 4.2% (P = 0.004), Tegner + 0.8 points (P = 0.04), IKDC + 9.8% (P = 0.02). The ROM was comparable between the two groups (P = 0.4). Similarity was found in terms of positivity to the apprehension test (P = 0.05), rate of complications (P = 0.1), re-dislocations (P = 0.8), and revision surgeries (P = 0.1).ConclusionThere is no evidence that adding a lateral release impacts positively on the outcome of MPFL reconstruction.Level of evidence: IV, Systematic review more...
- Published
- 2020
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