Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewWidespread Implementation of Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability Maintains Functional Outcomes at Midterm to Long-Term Follow-up While Decreasing Complication Rates: A Systematic Review
Section snippets
Methods
A systematic review of the literature was performed using the Medline, Embase, Scopus, and Web of Science databases. The purpose was to identify publications describing results of isolated MPFL reconstruction. The search was performed on January 12, 2014, and included publications that appeared in the literature as far back as 1992. The inclusion criteria were as follows: (1) The study must describe a technique for MPFL reconstruction in patients with chronic patellar instability with or
Results
Of the 34 publications included in this review, 15 had already been cited in prior systematic reviews whereas the remaining 19 represented new contributions to the literature. Of the 19 new studies, 18 were published by medical centers that had not previously reported outcomes with this procedure (31 total centers included) and represented an additional 621 patients and 650 knees (of 1,015 patients and 1,048 knees in total).
A comparison of our results by date of publication is shown in Table 4.
Discussion
The purpose of this review was to evaluate the midterm to long-term functional outcomes of the various surgical techniques that are in use for reconstruction of the MPFL. Surely, knowledge gained from early studies, refined techniques, and improvements in the rehabilitation process over recent years have affected the outcomes for the better; however, with the adoption of these new techniques across increasingly large physician and patient populations, it is necessary to consider whether the
Conclusions
With nearly twice the number of medical centers performing reconstruction of the MPFL and outcomes reported on nearly double the number of patients in recent years, functional outcomes remain favorable as complication and failure profiles are improving. Furthermore, despite a wide array of fixation techniques, as well as multiple options for graft constructs, there are no statistically or clinically significant differences in functional outcomes over time. This finding highlights the efficacy
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See commentary on page 1381
The authors report that they have no conflicts of interest in the authorship and publication of this article.